Heart bypass surgery or angioplasty?

Illustration showing the process of coronary artery stenting

CABGD, or heart bypass, is one of two techniques used in the treatment of CHD. The other is percutaneous coronary intervention (PCI), often called angioplasty and stenting. Both aim to improve the flow of oxygen-rich blood to the heart. The first heart bypasses were done in the 1960s, and the UK’s first coronary angioplasty was done in 1980, followed by the first coronary stent insertion in 1988.

Angioplasty is a minimally invasive method of widening a coronary artery. It uses a balloon catheter to widen the artery from within, and a stent is usually placed in the artery to keep it open. No anaesthetic is needed (although the patient may be offered sedation), and patients can often go home the same day or the next day.

The number of people having heart bypass has decreased by about a third in the past 10 years, which is linked to the development of drug-eluting stents that are used during PCI. Drug-eluting stents have a polymer coating that slowly releases a drug over time to help prevent the blockage from recurring.

The recovery time for angioplasty is much quicker than heart bypass, but angioplasty is not advisable for everyone with CHD. For example, people who have triple-vessel disease are recommended to have heart bypass, and if you have diabetes, heart bypass offers better survival outcomes. Angioplasty is often used for people with less-severe coronary artery disease.

When making a decision on whether heart bypass or angioplasty is indicated, doctors have guidelines and a scoring system to help them. It’s also important to involve the patient and their family in order to determine what the best option for the patient is.

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