Doctors sometimes need to do a special procedure to improve blood flow to the heart muscle when one or more of the heart's arteries are narrowed or blocked. Two commonly used procedures are coronary angioplasty and coronary artery bypass graft surgery. These procedures can be done during a heart attack or later.
While a heart attack is happening, the sooner these procedures are done, the greater the chances of saving heart muscle and of surviving a heart attack.
Coronary Angioplasty, or Balloon Angioplasty
In this procedure, a fine tube, or catheter, is threaded through an artery into the narrowed heart vessel. The catheter has a tiny balloon at its tip. The balloon is repeatedly inflated and deflated to open and stretch the artery, improving blood flow. The balloon is then deflated, and the tube is removed.
Doctors often insert a stent during the angioplasty. A wire mesh tube, the stent is used to keep an artery open after an angioplasty. The stent stays permanently in the artery.
In up to a third of those who have an angioplasty, the blood vessel becomes narrowed or blocked again within 6 months. This is more likely to happen if you smoke, or have diabetes or unstable angina. Vessels that reclose may be re-opened with another angioplasty or need a coronary artery bypass graft. Even an artery with a stent can reclose.*
Coronary Artery Bypass Graft Operation
Also known as "bypass surgery," the procedure uses a piece of vein taken from the leg, or of an artery taken from the chest or wrist. This is attached to the heart artery above and below the narrowed area, thus making a bypass around the blockage. Sometimes, more than one bypass is needed.
Bypass surgery may be needed due to various reasons, such as an angioplasty that did not sufficiently widen the blood vessel, or blockages that cannot be reached by, or are too long or hard for, angioplasty. In certain cases, bypass surgery may be preferred. For instance, it may be used for persons who have both coronary heart disease and diabetes.
A bypass also can close again. This happens in more than 10 percent of bypass surgeries, usually after 10 or more years.
Source: National Heart, Lung and Blood Institute
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