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For a subset of heart patients who are both diabetic and have more than one clogged artery, bypass surgery appears to outperform the use of artery-widening stents, a major new trial finds. The study adds more evidence that bypass is the preferred approach for this type of patient, according to experts discussing the findings Sunday at the annual meeting of the American Heart Association in Los Angeles. "This has the potential to change clinical practice," said Dr. Alice Jacobs, director of the Cardiac Catheterization Laboratory and interventional cardiology at Boston Medical Center. In her commentary, she said the results of...

ASSOCIATED PRESS ALBANY, N.Y. -- A report detailing the performance of 37 hospitals in New York shows mortality rates for heart surgeries declining, but critics say the information should be released faster and cover a broader range of procedures. The report, which lets patients see which hospitals and surgeons have the best track records, shows that in 2003 the statewide mortality rate for patients undergoing coronary artery bypass surgery was 1.61 percent. When the state first began tracking the surgeries in 1989, the mortality rate was 3.52 percent. The improved mortality rate is being driven in part by the public...

The condition for which former President Bill Clinton will undergo elective surgery on Thursday is a complication that occurs in fewer than 1 percent of coronary bypass patients, his doctors said yesterday. The complication, in which fluid and scar tissue compress and collapse a lobe of the left lung, is not expected to recur, the doctors said at a news conference at NewYork-Presbyterian/Columbia University Medical Center. The doctors said they expected that Mr. Clinton "will resume his work without limitations" within a month. Doctors not involved in Mr. Clinton's care agreed that the complication was unusual and did not pose...

LAST RESORTS COLUMBUS, Ohio — Lying on the operating table, his thin arms outstretched to either side, Ric Ray spoke little as doctors and nurses in masks and scrubs descended on him with needles, scalpels and intravenous lines. It was 7:35 a.m. Shaving Mr. Ray's chest with a few quick razor strokes, an anesthesiologist asked, "When was your heart attack?" "March 8, 1987," Mr. Ray replied. "How old were you?" "Thirty-five," Mr. Ray said softly. The heart attack did so much damage that Mr. Ray's heart never recovered, but weakened steadily over the years. In 1990, when his daughters were...