“What is the difference between an angioplasty and a by-pass surgery?”
My father has been detected with a blockages in his artery. He is currently 70 years of age and has other medical conditions like high blood pressure. Given his age and health condition, would you suggest an angioplasty or a by-pass surgery? What are the major differences between the two?
6 Answers
Angioplasty is where we insert tiny balloons in your heart arteries and open a blockage. Bypass surgery is where we take veins from your leg and bypass the blockage in your heart arteries. That does involve open heart surgery
Angioplasty (or stent) is less invasive and no incision is needed and is typically an overnight stay procedure. On the other hand, bypass means opening the chest wall and harvesting vessels from the chest wall and from one of the legs. The surgery requires bridging blood circulation from a spot above the blockage to a spot below the site of the blockage by using the harvested vessels. Also, there's a hospital stay for bypass surgery, usually from 4-7 days. This would depend on many factors, associated comorbidities or not (strong, healthy heart muscle vs. damaged, weak heart), other organs failure, such as kidney failure, or serious lung problems. Are there good sources of vessels to have the from?
Generally, bypasses are more durable than stents. Again, this is if the patient turns out to have a good caliber and good quality bypass conduits, which is typically used to bridge the blood from before the the blockage to after the blockage. Also, the rest of the blocked coronary artery we are doing surgery on has to be good for the bypass durability.
Many variable should be taken into consideration when deciding which is better for the patient. Sometimes you can choose either treatment without altering the patient outcome and lifestyle. In certain situations, the surgeon and the intervention cardiologist have to agree on one best form of treatment.
Nowadays, with the availability of much better stents, devices, and modern imaging modalities, the prevalence of stent in treatment of serious coronary artery disease has been rising steadily and has become more effective with acceptable risks of renarrowing.
I advise your father and your family to discuss his option of treatment and the pros and cons.
Generally, bypasses are more durable than stents. Again, this is if the patient turns out to have a good caliber and good quality bypass conduits, which is typically used to bridge the blood from before the the blockage to after the blockage. Also, the rest of the blocked coronary artery we are doing surgery on has to be good for the bypass durability.
Many variable should be taken into consideration when deciding which is better for the patient. Sometimes you can choose either treatment without altering the patient outcome and lifestyle. In certain situations, the surgeon and the intervention cardiologist have to agree on one best form of treatment.
Nowadays, with the availability of much better stents, devices, and modern imaging modalities, the prevalence of stent in treatment of serious coronary artery disease has been rising steadily and has become more effective with acceptable risks of renarrowing.
I advise your father and your family to discuss his option of treatment and the pros and cons.
By pass is a surgical procedure while angioplasty does not
Julia G. Ansari
Cardiologist
Angioplasty is hardly used alone these days. Angioplasty means dilating the blockage with use of a balloon which is followed by placement of a stent. Bypass is used when there is extensive three vessel blockage. Stenting is used for focal disease in one or two vessels.
Bypass surgery is usually an open heart surgical procedure, although some can be done through "minimally Invasive" or "keyhole" surgery. It is often done for more advanced blockages, particularly if multiple arteries are involved or if the heart is weak.
Angioplasty, Stent or PCI all mean that it is a procedure done with catheters rather than an open surgery. It is used most often for single blockages where medications have been inadequate to control chest pains.
Which is best suited is dependent on the extent of blockages and what other medical conditions the individual may have and is a case by case decision and best advised by the person who did the angiogram Cardiac catheterization procedure that found the blockage.
Dr. A. Shekhar Pandey, B.Sc., MD, FRCPC, ABIM, CBNC
Angioplasty, Stent or PCI all mean that it is a procedure done with catheters rather than an open surgery. It is used most often for single blockages where medications have been inadequate to control chest pains.
Which is best suited is dependent on the extent of blockages and what other medical conditions the individual may have and is a case by case decision and best advised by the person who did the angiogram Cardiac catheterization procedure that found the blockage.
Dr. A. Shekhar Pandey, B.Sc., MD, FRCPC, ABIM, CBNC
Angioplasty is inserting a wire and stent into an artery, may go home the next day, but patients must be appropriate candidates. Bypass is opening the chest and harvesting arteries and veins from your body, much longer and complicated, but in certain patients a better treatment option.
