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Many patients can control their heart
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.
Types of Heart Surgery
Coronary angioplasty
or balloon angioplasty. A small tube
(catheter) is put into an artery of an arm or leg and passed through
the tube into the arteries of the heart.
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
operation, 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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