CAD Surgical Procedures

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CAD Surgical Procedures

Posted: March 1, 2007

Angioplasty or bypass surgery may be used to treat coronary artery disease (CAD) if:

Medicines and lifestyle changes have not improved your symptoms.
Your symptoms are getting worse.

Some people may need to have angioplasty or bypass surgery on an emergency basis during a heart attack to limit damage to the heart.

Coronary angioplasty
Coronary angioplasty is a medical procedure used to restore blood flow through a narrowed or blocked artery in the heart. The arteries of the heart (the coronary arteries) can become narrowed and blocked due to buildup of a material, called plaque, on their inner walls. This narrowing reduces the flow of blood through the artery and can lead, over time, to coronary artery disease and heart attack.

In angioplasty, a thin tube with a balloon or other device on the end is first threaded through a blood vessel in the arm or groin (upper thigh) up to the site of a narrowing or blockage in a coronary artery. Once in place, the balloon is then inflated to push the plaque outward against the wall of the artery, widening the artery and restoring the flow of blood through it.

Angioplasty was first used in 1977. A tiny balloon was used to open or widen narrowed arteries. Since then, new devices and medicines have improved the procedure and made it appropriate for more people. The improvements include:

Stents. A stent is a tiny mesh tube that looks like a small spring. The stent is inserted in the area where the artery is narrowed to keep it open. Some stents are "coated" with medication to help prevent the artery from closing again. Stents are used in most angioplasties except when an artery is too small for a stent to fit.
Plaque removers. These are used to cut away plaque that narrows the inside of the arteries.
Laser. A laser is used to dissolve or vaporize plaque. First approved in 1992, laser devices are used in many major U.S. medical centers.

Coronary artery bypass surgery
Bypass surgery improves the blood flow to the heart with a new route, or "bypass," around a section of clogged or diseased artery. Bypass surgery can improve blood flow to your heart, relieve chest pain, and possibly prevent a heart attack.

The surgery involves sewing a section of vein from the leg or artery from the chest or another part of the body to bypass a part of the diseased coronary artery. This creates a new route for blood to flow, so that the heart muscle will get the oxygen-rich blood it needs to work properly.

During bypass surgery, unlike other forms of heart surgery, the chambers of the heart are not opened during the operation.

Source: National Heart, Lung and Blood Institute

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