Angioplasty is a procedure that opens blocked coronary arteries and restores blood flow to the heart muscle. When applicable, angioplasty is a much less invasive solution than open-heart surgery.
During angioplasty, a long, thin tube (catheter) with a tiny balloon at its tip is placed inside a blood vessel and then into the blocked coronary artery. Once in place, the balloon is inflated at the narrowed area of the heart artery to push back any blockage or clotting out to the sides of the artery. This additional space allows more room for blood to flow through to the heart.
While angioplasty may be used as an emergency treatment for a heart attack, it can also serve as an elective proactive surgery if heart disease is suspected. Often those who receive angioplasty are released from the hospital after a day or two, depending on diagnosis and circumstances.
A stent is a tiny, expandable metal mesh coil inserted into an artery during angioplasty to help keep the artery from narrowing or closing again. In over a third of patients who’ve had angioplasty without a stent, the artery that was opened begins to narrow again within months of the procedure. That’s why coronary stents are now used in almost all angioplasty procedures.
Most stents are coated with medicine to prevent scar tissue from forming inside the stent. These stents are called drug-eluting stents (DES). They release medicine within the blood vessel that slows the overgrowth of tissue, slowing down the re-narrowing of the artery. Some stents—
bare metal stents (BMS)—are not coated with medication. With these stents, the artery may narrow faster, but they don't require long-term use of antiplatelet medicines. This stent may be a better choice if you are at a high risk of bleeding.
Either type of stent can become blocked over time, with scar tissue forming around or inside them. When this happens, your doctor will work with you to determine the best way to approach a repeat procedure.
As with angioplasty, the goal of an atherectomy is to make space in a blocked artery to increase blood flow to the heart. The difference is that an atherectomy procedure creates this space by directly removing plaque from the artery walls versus simply pushing it out of the way. The plaque is shaved or vaporized away with tiny rotating blades or a laser on the end of a catheter (a thin, flexible tube).
In addition to being used for peripheral and coronary artery diseases, an atherectomy may be in order if you have very hard plaque in your arteries; or have already had angioplasty and stents without experiencing a long-lasting return of healthy blood flow to the heart.
Coronary bypass surgery is another treatment option if you have a blocked artery to your heart.
It works by redirecting blood around the blocked section of artery to improve blood flow to your heart muscle. Generally, this means moving a healthy blood vessel from another part of your body and using it to ‘bypass’ the blocked artery or arteries in your heart.
While not a cure for heart or arterial disease, it can ease symptoms such as chest pain and shortness of breath and can help to prevent heart attacks. It can also be a life-saving procedure during a heart attack.
Minimally invasive heart surgery
Whenever possible, minimally invasive heart surgery is recommended by our highly skilled cardiac surgeons and the technology is advancing all the time. During minimally invasive heart surgery, our surgeons make tiny chest incisions to access your heart through openings between the ribs. Cutting-edge, high-resolution imaging technology is used in the operating room, providing precisely detailed, 3-D images of your beating heart to your surgeon in real time, for the best possible outcome.
- No opening of the chest or cutting of bones
- Faster recovery
- Less pain
- Lower risk of complications
- Decreased blood loss and need for blood transfusion
- Less scarring
- Less time in the hospital