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Differences between angioplasty and bypass surgery

Angioplasty vs Bypass surgery

With the rising number of heart disease patients, heart surgery has become fairly common. Of course, that doesn’t reduce the cost, the risk or the fear for one undergoing such a surgery. Knowing what the two commonest forms of heart surgery entail might make it easier to accept the procedure.

Angio = vessel and plasty = moulding. Angioplasty is essentially a procedure where a small stent is placed inside the blocked artery that supplies the heart. The artery might have been blocked due to ageing by a process called arteriosclerosis or due to cholesterol deposits. In either case, the stent, which is a few millimetres long, soft metal tube, is placed precisely at the spot of the narrowing. Before the stent is placed, the narrowing is made wider using a small, inflatable balloon after which the stent is put in place. The stent can be medicated or plain and keeps the narrowed tube patent thereafter, restoring complete blood flow to the heart.

A coronary artery bypass graft surgery or more commonly, a bypass surgery, is like creating a diversion on the road by redirecting the traffic onto another lane. Using other healthy veins/arteries from the body as grafts, the blocked arteries of the heart are bypassed and the grafts are fitted in place such that the affected region of the heart gets a full blood supply again.

An angioplasty is performed when the blockages are less than three or if the person is unwilling for a bypass. A bypass surgery is always preferable if there are more than 2 blocked arteries. An angioplasty is a much shorter procedure, with the actual procedure lasting under an hour. Bypass surgery also called open heart surgery, is fairly longer, lasting between 3-6 hours, depending on the number of arteries being bypassed. The patient is mostly kept awake and conscious during an angioplasty. Only a local anaesthetic is given in the region from where the guide wire is inserted. During a bypass surgery, the patient is kept unconscious during the entire procedure.

Also, the procedures themselves are so very different that it makes the doctor’s skill and experience a concern. In an angioplasty, the entire procedure of unblocking the artery using a balloon and stenting it, is done using a guide wire passed in through an artery in the arm or thigh. The amount of skill required is a lot, but the risks are lesser when you compare it to a bypass surgery. During a bypass surgery, the rib cage is opened to access the heart, arteries manually removed from the chest or the thigh region and stapled into place in the heart to restore blood supply to the affected region. An experienced doctor will do a job so good that the new grafts will never give you any trouble for the remainder of your life. Stents, in fact, have the risk of collapsing in the first one year after placement. In such a case, one has to opt for an emergency bypass surgery.

Take home pointers:

Angioplasty involves placing a tiny metal tube inside the blocked artery of the heart to restore blood flow. Bypass surgery involves replacing old blocked arteries with new, patent ones from the patient’s own body.
Angioplasty is shorter, easier, has less recovery time and lesser risks.
Bypass surgery is longer, requires greater skill and precision, has a longer recovery time and more risks during procedure.
Cost-wise the difference is not too significant between the procedures.
Both the procedures are equally beneficial, although the skill of the doctor is an important deciding factor in the outcome.

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