“What is the difference between a bypass surgery and an angioplasty?”
I am a 54 year old man and the doctors have detected 4 blockages in my heart. I have an option of getting bypass surgery or an angioplasty. What is the difference between the two?
8 Answers
This is a question that requires a prolonged discussion with a cardiologist over your particular medical situation. Angioplasty in 2019 involves placing a stent in the coronary arteries, delivered by a plastic catheter from your arm or groin, to push away the blockage and restore normal blood flow to the heart muscle. This is done in a catheterization room with the patient under sedation. Coronary bypass surgery is surgery, done under general anesthesia, where arterial and veins are used to literally "bypass" the obstructions in the coronary arteries.
Bypass surgery (CABG) is open heart surgery where they open your chest and use blood vessels from your chest or leg to bypass (route blood flow around blockages). Angioplasty is a less invasive modality where catheters are inserted into the opening of the coronary arteries and a wire advanced across a blockage. A ballon is often inserted over the wire and inflated to open the blockage restoring improved blood flow often in conjunction with a stent. Usually the best option with multi vessel disease (2 or more coronary arteries are involved) is CABG however every case is individualized and a detailed conversation held with your physician as to the pros and cons of each option
Blockages can be obstructive, more than 75-80% of the inside diameter of the coronary artery or less than 75%. If it is more than 75%, then the options are angioplasty which usually means placing cardiac stents into the arteries to open the blockage up and allow blood to flow through the artery again. This is done through a cardiac catheterization.
A bypass surgery is an open heart surgery where a surgeon opens your chest up and uses veins and/or arteries from other places in your heart to bypass or go around the blockages to supply blood to the areas of the heart past the blocked arteries.
A bypass surgery is an open heart surgery where a surgeon opens your chest up and uses veins and/or arteries from other places in your heart to bypass or go around the blockages to supply blood to the areas of the heart past the blocked arteries.
They are very different procedures, angioplasty involves putting stents in the arteries to open the blockages, usually during a brief hospital stay. Bypass surgery involves open heart surgery and placing vein or artery segments to bypass the blockages. Also, this results in a longer hospital stay. Both procedures will improve symptoms, but only bypass surgery has been shown to improve survival.
Julia G. Ansari
Cardiologist
Bypass is open heart surgery where they use vein from leg or artery from breast to bypass the segment of artery that has blockage. Angioplasty is ballooning the segment of artery that has plaque and pushing it to the side so you open up blood flow to arteries. These days angioplasty is followed by stenting. Stenting is usually for focal disease, while bypass is for diffuse disease involving multiple arteries.
Angioplasty is less invasive - the blockages were most likely determined by cardiac catheterization- angiography. The angioplasty is performed via same technique of angiography percutaneously - the blockages are attempted to be dilated and stent deployed to open the blockages - bypass is bypassing the blockages - more initial post procedure risks as hospitalization - wound issues , longer recovery - but more long term revascularization- whereas angioplasty may have to be repeated more often if lesions recur
Without knowing your anatomy (coronary) I would think surgery, most important, are diabetes, where the disease is located, your dad's symptoms, and his heart function. Not an easy question, but a good start. I can help more if you like!
Bypass surgery is probably the best possibility and is an open heart surgery. Angioplasty is an interventional procedure without opening the chest.
