Your questions about coronary angioplasty or bypass surgery, answered

Making decisions concerning heart surgery can be challenging for patients and their families. Such conversations often end in anxiety, uncertainty, and a lot of concerns about the future. Often, patients also have many questions regarding their surgical choices. It is important to speak to your doctor to have the following questions answered, in order to be sure you are making the right choice and, consequently, getting the best surgical outcome for you.

If my medication is already helping me, why should I go through this process?

Coronary artery disease (CAD) symptoms are treated with medicines, which also slow the condition’s development. CAD is very dynamic, which means it is subject to change over time. Sometimes, after the number of blockages rises, the location and/or severity of the blockages can stop adequate oxygenated blood from reaching the heart muscle with medicine alone. A procedure could be the only method to prevent a heart attack, congestive heart failure, or an abrupt decline in one’s health when an inspection finds a severe blockage and/or inadequate blood flow to the heart.

What is the difference between angioplasty and coronary artery bypass grafting?

Angioplasty is a less invasive surgery that opens blockages in blood vessels by inserting a balloon through them using a catheter. The doctor inserts a stent to keep the blockage open once it has been cleared. When there is only one obstruction or a little blockage, this kind of surgery is most effective. A more intrusive form of cardiac surgery is coronary artery bypass graft surgery. During this treatment, the surgeon will use other bodily channels to build a new route for blood to travel around the blocked coronary arteries. This kind of operation usually occurs in cases of patients with diabetes with several coronary blockages, left main artery disease, multiple blockages, and/or reduced heart function.

How is the decision made between angioplasty and bypass?

The decision is based on the coronary angiography indicators, which indicate the number and severity of blockages; any other diseases, such as diabetes or renal impairment; and the total risk of the operation for patient. Cardiologists and surgeons working together as a cardiac team will ensure that the patient gets the most efficient and durable treatment.

How safe are these surgeries today?

In contrast to earlier times, improvements in anesthesia, surgical methods, and technology have helped boost patient survival rates and enhance safety. Modern bypass surgery involves the use of artery grafts, combined with precise surgical procedures, which lead to quicker recoveries. Modern angioplasty makes use of cutting-edge imaging technologies. When these treatments are carried out on time, they offer excellent outcomes for patients.

What does recovery look like and what are the long-term benefit?

Following an angioplasty or bypass surgeries, many patients will see a significant reduction in their symptoms, will be able to be far more active than they were before, and will have an improved quality of life. With bypass surgery, there is necessarily a longer period of recovery that requires rehabilitation, whereas angioplasty recovery times are usually fast. Lifestyle modifications, medication adherence, and continued medical care are all essential to ensuring treatment is effective.

What is important to remember is that heart treatments are not only beneficial but are also preventative. The patient’s chances of living a longer and better life are greatly increased when the appropriate intervention (angioplasty or bypass surgery) is chosen at the right time.

(Dr. Abhijit Joshi is head of department and consultant, cardiology, Manipal Hospital, Baner, Pune)