Many patients can control coronary artery disease with lifestyle changes and medication.
Surgery may be recommended for patients who continue to have frequent or disabling angina despite the use of medications, or people who are found to have severe blockages in their coronary arteries.
Coronary Angioplasty or balloon angioplasty begins with a procedure similar to that described under angiography.
However, the catheter positioned in the narrowed coronary artery has a tiny balloon at its tip. The balloon is inflated and deflated to stretch or break open the narrowing and improve the passage for blood flow. The balloon-tipped catheter is then removed.
Strictly speaking, angioplasty is not surgery. It is done while the patient is awake and may last 1 to 2 hours. If angioplasty does not widen the artery or if complications occur, bypass surgery may be needed.
In a Coronary Artery Bypass, a blood vessel, usually taken from the leg or chest, is grafted onto the blocked artery, bypassing the blocked area. If more than one artery is blocked, a bypass can be done on each. The blood can then go around the obstruction to supply the heart with enough blood to relieve chest pain.
Bypass surgery relieves symptoms of heart disease but does not cure it. Usually you will need to make a number of changes in your lifestyle after the operation. If your normal lifestyle includes smoking, a high-fat diet, or no exercise, changes are advised.
Several experimental catheter-surgical procedures for unblocking coronary arteries are under study; their safety and effectiveness have not yet been established. They include:
- Atherectomy: a procedure in which surgeons shave off thin strips of the plaque blocking the artery and remove these strips
- Laser Angioplasty: instead of using a balloon to open up the blocked artery, doctors insert a catheter with a laser tip that burns or breaks down the plaque.
- Insertion of a Stent: a metal coil that can be permanently implanted in a narrowed part of an artery to keep it propped open.
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