Angioplasty vs bypass: Cardiologist explains which one is better based on blockages, age and overall health

Angioplasty is a non-surgical substitute for bypass surgery. But is it effective? In an interview with HT Lifestyle, Dr Rushikesh Patil, associate director, cardiologist, Dr L H Hiranandani Hospital Powai, Mumbai explained, “The procedure involves access to the artery (usually from the wrist or groin) with local anesthesia, insertion of a sheath, placement of catheters to the coronary artery using fluoroscopy, and advancing a wire through the blockage. A balloon is inflated on the spot, and a metal stent coated with medication is placed in to maintain the openness of the artery. The recovery is quick with an average hospital stay of 1 to 2 days.” Also read | Cardiologists says he wishes more people knew how to ‘avoid open heart surgery’: No chest cutting, bypass machine needed

Know when is angioplasty preferred.(Unsplash)

When is angioplasty preferred?

In these cases, angioplasty is the best option, shared the cardiologist:

Localised tubular or major vessel proximal blockage
Patients at surgical risk due to age, frailty or other illnesses such as Parkinson’s disease, other serious lung disease, or kidney disease
Emergency conditions such as acute myocardial infarction
Patients with bypass history and failed result following the procedure.

When is bypass surgery the right option?(Freepik)

How is bypass surgery done?

“A Surgical Alternative Coronary Artery Bypass Grafting (CABG) is open-heart surgery if the blocked coronary artery is bypassed using a healthy blood vessel from the arm, leg, or chest. Basically, a detour for blood. The hospitalisation is 5–7 days, and double that to get over,” said Dr. Rushikesh Patil. Also read | Minimally invasive cardiac surgery: Heart risks for your parents, benefits, lifestyle changes, recovery secrets

When is bypass surgery preferred?

The routine recommendation for CABG is:

• Severe coronary artery disease or chronic total occlusions in more than one vessel Diabetics or small-vessel disease Obstructions in distal left main artery Angioplasty failure or complication cases

• In general, CABG is not the recommendation in heart attack emergencies, unless there are mechanical complications such as septal rupture.

Making the right choice

“Opt for Angioplasty for quick rehabilitation, less short-term risk. Opt for CABG if there is a superior future prognosis with more severe or complicated disease, especially for diabetics or multi-vessel disease patients. Your physician will determine what is best for you based on how many, what kind, and where the blockages are, and your age, health status, and other related health issues. Making a decision early is critical to your overall heart health,” said the cardiologist. Also read | Just had a bypass? Follow these 18 golden rules for a stronger heart after bypass surgery

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.