Comparing Angioplasty to Bypass Surgery: Which Option is Right for You?

Angioplasty and bypass surgery are two common surgeries done in patients with Coronary Heart Disease (CHD) secondary to occlusion or stenosis of arteries. Thus, both are designed to help increase blood flow through the heart by opening a blocked artery. Arteries are vessels that supply oxygenated blood from the heart to all other parts of the body.

The plaque can build up on the insides of arteries, impeding blood flow that is full of oxygen and preventing it from getting to different places in your body. Worst, blocked arteries may also push an illness like a heart stroke or even cardiovascular stress.

Detection and early treatment can prevent or manage artery blockages with treatments like angioplasty or bypass surgery. Best angioplasty expert in India offer all-inclusive healthcare services for the diagnosis, treatment, and follow-up care of coronary diseases. But which is the better alternative?

Let us discuss.

Defining Angioplasty

It is a minimally invasive surgical method. The process helps treat blockage in either of the two arteries.

The steps include

1. You lie down on the X-ray table.
2. A local anaesthetic or even an IV line can be given, including painkillers, sedatives, and/or contrast dye.
3. An artery in your groin, arm, or wrist is used to make a small incision.
4. A sheath is placed in the artery to keep it open.
5. Next, a catheter is passed via the sheath.
6. The doctor then inserts a tiny balloon on a slender wire.
7. The balloon goes via your coronary artery through the catheter.
8. It inflates the balloon for 20–30 seconds, which expands your artery.
9. When a stent is needed, the balloon puts it in its place.

When is it Done?

The best angioplasty experts in India and abroad recommend this method:

1. In case of a heart attack
2. To avoid a heart attack
3. Spontaneous coronary artery dissection

Doctors state that the procedure can improve blood flow through the coronary artery in most cases.

It can be a life-saving treatment after a heart attack. However, whether it can improve the outlook for patients with stable CAD is controversial.

Defining Bypass

Bypass is a surgical treatment wherein a new path is formed for a seamless flow of blood around a blocked or partially blocked artery.

The steps include

1. You receive general anaesthesia via IV.
2. A surgeon cuts along your sternum, and then pries open, like a chest of drawers, your rib cage.
3. A medicine makes your heart stop. To replace your heart and lung function, you are hooked up to a machine.
4. After fasting, the surgeon opens an artery in your leg or arm. You might need more than one graft.
5. The surgeon will use this blood vessel to create a bypass around your blockage.

In some cases, the doctors do the bypass without stopping your heart.

When is it Done?

It is often an emergency treatment for a heart attack. Bypass can lower the death rates by up to a decade compared with medications alone in people with inadequate blood flow to the heart and reduced left ventricular function.

Doctors recommend it in the following cases

1. Blockage in the left main artery of the heart
2. Narrowing of the left main artery
3. Narrowing of several heart arteries, causing chest pain
4. Inability to treat the blocked artery with angioplasty
5. Failure of a past angioplasty surgery

Those who undergo a bypass have

1. Better survival rates
2. Improved life quality
3. Less angina

Difference between Bypass and Angioplasty

Invasiveness

Angioplasty is minimally invasive. Bypass involves large incisions on the chest and the leg.

Time

The angioplasty procedure takes between 30-120 minutes, whereas the bypass will take about 3-6 hours.

Risks

Both procedures have their share of risks. Basis the factors involved and the severity of heart disease, there is a certain risk of death in both.

Let us discuss the other risks involved.

Angioplasty

1. Damage to the arteries
2. Heart attack
3. Stroke
4. Allergic reaction to the contrast dye
5. Bleeding that demands a transfusion

Bypass

1. Infection
2. Stroke
3. Reduced kidney function
4. Atrial fibrillation
5. Heart attack, especially within a month of the surgery

Preparation

Angioplasty

You will have to stop taking blood thinners.

Bypass

The recovery window is long. So, prepare by

1. Stocking up on easy-to-make foods
2. Having help for at least two weeks
3. Getting someone to drive back home after the procedure.
4. Making changes around the house for easy mobility

Recovery

Angioplasty

You might need to spend the night in a hospital or go home the same day. Many people who have a nonemergency coronary angioplasty can return to work after around one week.

Bypass

After your procedure, you may need to be hospitalised for about seven days. Nearly all people recover fully within three months.

Bottom Line – Which is better?

Angioplasty is faster. It is less invasive than bypass. On the contrary, bypass is a better selection if you have a blockage in the larger left coronary artery or multiple blockages. The doctor will take into account various factors to determine which is the better-suited alternative for the patient.

Some factors that surgeons consider are

1. Patient’s health
2. Medical history
3. Overall heart function
4. Extent and severity of CAD
5. Accompanying symptoms – breathlessness and chest pain
6. Patient’s personal preference
7. Other medical conditions that may impact the outcome, such as diabetes, prior history of stroke, high blood pressure

Consult Dr Raghu, one of the best angioplasty experts in India, to learn which alternative you should choose. He will help you with a personalised treatment plan for your condition.

Source Link : ahajournals.org