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Heart Trouble

The tiny stent sparked a lucrative industry--and made Dr. Samin Sharma a star. Then questions arose about the device's safety and efficacy.

On a sweltering summer morning, Dr. Samin K. Sharma marches into the cardiology wing of Mount Sinai Hospital in New York, prepared for a 16-hour day in which he will clear and repair the arteries of 18 patients. Sharma specializes in installing stents, tiny metal devices that hold open blocked blood vessels. As he'll be the first to note, he does more stent procedures than anyone else in doctor-rich New York and possibly in the entire country. An immigrant from India who had to plead for his first cardiology job here, he has played a critical role in popularizing the stent as an alternative to drugs. In the process, he has helped fuel a booming stent market and revive the fortunes of Mount Sinai, a prestigious old institution that just a few years ago was stumbling financially.

But this morning a slight shadow of doubt hangs over the court of the King of Stents. On the table, patient David Viggiano is asking questions. (Although sedated, stent patients remain awake.) Viggiano, a 42-year-old security guard with colorful tattoos on his arms, suffered a heart attack three years ago near his home in suburban New York. He was riding his bicycle through a cemetery, a setting that still haunts him. As he awaits his procedure, Viggiano is aware that qualms have arisen over certain kinds of stents. "I heard they had problems," he says, as an X-ray machine whirs back and forth over his chest.