Heart surgery is a common treatment for coronary heart disease, and two of the common types are angioplasty and bypass surgery. These procedures may be done to relieve chest pain or to decrease the risk of a heart attack.
Both types of heart surgery are done to prevent damage to the heart from a narrowed or blocked coronary artery. These arteries carry oxygenated blood to the heart muscle. When the heart muscle does not get enough blood, chest pain or a heart attack can result. The reason for the blockage is a buildup inside the artery of fat, cholesterol, and other substances that forms into a plaque.
Angioplasty is more of a heart procedure than an actual heart surgery. The procedure is performed while the patient is awake, and it is not necessary for a cardiac surgeon to open the chest.
Here is what happens during angioplasty:
- A small incision is made, usually in the groin area, to expose an artery leading back to the heart.
- A thin, flexible tube called a catheter is inserted into the artery and guided upward into the area of the heart where the coronary artery is blocked.
- X-ray pictures and injected dyes are used to see the catheter, the heart, and the coronary arteries.
- Once the blockage is located, a wire inside the catheter is pushed through the blocked area and a balloon at the end of the catheter is inflated to force the artery open.
- A wire mesh tube called a stent may be left in place to keep the artery open.
- Patients usually stay in the hospital less than two days and then recover at home in about a week.
Unlike angioplasty, bypass surgery is a major surgical procedure and involves an incision through the breastbone so the cardiac surgeon, or surgeons, can see the heart. Besides the cardiac surgeons, a large team of specialists will be present, including a cardiac anesthesiologist, nurses, and a blood flow specialist.
Here is what happens during this type of heart surgery:
- After the cardiac surgeon opens the chest, the blocked coronary artery or arteries are identified.
- A healthy blood vessel from another part of the body is selected to go around, or bypass, the blocked areas. This blood vessel may be taken from inside the chest or from a vein in the leg.
- The cardiac surgeon sews the new blood vessel, called the graft, above and below the blocked coronary artery. One to four arteries may be bypassed with a graft during bypass surgery.
- In most cases the heart is stopped and blood is oxygenated and pumped through the body by a heart-lung machine.
- The entire surgery can take from four to six hours.
- After surgery, patients are taken to the intensive care unit until they are stable.
- Patients usually stay in the hospital for about six days. Once they are home, they begin a cardiac rehabilitation program.
Heart Surgery: The Recovery Process
Most people recover well from both angioplasty and bypass surgery. Possible risks from bypass surgery include:
- Heart attack
- Wound infection
- Chest pain lasting for several months
- Mild memory loss or difficulty concentrating and thinking clearly
- Heart rhythm problems
Possible risks from angioplasty include:
- Heart attack
- Allergic reactions to the dye and maybe the stent
- Bleeding from the area where the catheter was inserted
- Damage to a heart valve
It is important to remember that neither heart surgery nor angioplasty is a cure for coronary artery disease. Even after a bypass surgery graft or an angioplasty stent is placed, there is always the danger that another artery will become blocked or the stent will become blocked by coronary heart disease.
The best way to prevent future coronary heart disease is to work with your doctor, not smoke, reduce stress, eat a heart-healthy diet, and maintain a program of regular exercise.
Learn more in the Everyday Health Heart Health Center.