Surgeons make an eight to ten inch sized cut in the chest to get to the heart and conduct the procedure. The patient is given general anaesthesia to ensure the whole process is pain-free.
Recovery time can take up to 12 weeks, including a brief one or two-day stint in the ICU. While neither of these procedures provides solutions that will last forever, angioplasties are less permanent than bypass surgeries as they do not correct the underlying cause of the blockage.
In both cases, patients are required to change their diet and follow an exercise routine to burn excess fat or cholesterol. Angioplasty is a procedure wherein a balloon-tipped catheter is threaded to the site of the arterial blockage through a small incision in the groin or arm. This balloon is then expanded to widen the narrowed artery. The most important artery is called the left anterior descending artery LAD. It feeds blood to the whole front wall of the heart, which represents much more muscle than the area fed by either of the other two coronary arteries.
A narrowing or blockage in the LAD is more serious than narrowing or blockage in the other arteries. Bypass surgery usually is the best choice for a blocked LAD.
If the LAD is not blocked, and there are no other complicating factors, stents are more likely to be used, even if both of the other arteries are blocked. One major factor is that LAD bypass uses another artery—the mammary artery, located in the chest near the heart—for the graft.
Complications are rare, and CABG using the mammary artery lasts for decades. Moreover, for reasons still unknown, the mammary artery is nearly immune to blockage. Medical therapy here means medication and follow-up visits with your cardiologist, but no invasive interventions such as bypass or angioplasty. These procedures typically use veins rather than arteries, and in half of people, these repurposed veins start to fail after eight to 10 years. For people with diabetes, there are fewer questions regarding the choice between bypass surgery and stents.
Bypass surgery is generally superior to angioplasty. When more than one heart artery is blocked, CABG may also offer better survival rates for people with heart failure. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. Our Housecall e-newsletter will keep you up-to-date on the latest health information. Mayo Clinic does not endorse companies or products.
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