CABG (coronary artery bypass graft) - Alternatives to a coronary artery bypass
- Introduction
- Preparing for a coronary artery bypass graft
- What happens during coronary artery bypass surgery
- Recovering from coronary artery bypass surgery
- Risks of surgery
- Life after a coronary artery bypass
- Alternatives to a coronary artery bypass
- 'The secret is to stay positive'
If you have coronary heart disease and the arteries around your heart are severely narrowed, it may be possible to have a procedure called a coronary angioplasty instead of a coronary artery bypass graft (CABG).
Coronary angioplasty
During a coronary angioplasty, a long, flexible plastic tube called a catheter is inserted into a blood vessel, either in your groin or your arm.
The tip of the catheter is guided under X-ray to the arteries that supply your heart, to the point where the narrowing of the artery has occurred.
A balloon attached to the catheter is then inflated to widen the artery and a small metal tube called a stent is often left in the affected section of artery to help keep it open.
Serious complications of a coronary angioplasty are uncommon, but heart attacks, strokes and deaths are estimated to occur in less than one in every 100 cases.
A coronary angioplasty may not be recommended if multiple coronary arteries have become blocked and narrowed. It may also not be technically possible if the anatomy of the blood vessels near your heart is abnormal.
Which procedure is best?
You may not always be able to choose between having a coronary angioplasty or a CABG, but if you are it's important to be aware of the advantages and disadvantages of each technique.
As a coronary angioplasty is minimally invasive, you will recover from the effects of the operation quicker than you will from a CABG. Coronary angioplasty usually has a smaller risk of complications, but there is a chance you will need further treatment because the affected artery may narrow again.
However, the number of people who need further treatment has fallen in recent years because of the use of special drug-eluting stents that reduce the risk of the artery narrowing again. See how a coronary angioplasty is performed for more information about these.
CABG has a longer recovery time than coronary angioplasty and a higher risk of complications. However, only one person in 10 who has a CABG requires further treatment. Also, some evidence suggests that CABG is usually a more effective treatment option for people who are over 65 years of age and particularly for people with diabetes.
If possible, you should discuss the benefits and risks of both types of treatment with your cardiologist and cardiac surgeon before making a decision.
Medication
In some cases, it is possible to treat coronary heart disease with a number of different medications, such as:
- antiplatelets – to help prevent your blood from clotting and reduce your risk of problems such as heart attacks
- statins – to help reduce high cholesterol
- beta-blockers and nitrates – to help prevent angina and treat high blood pressure
These medications can help control some of the symptoms of heart disease and can reduce the risk of the condition getting worse, but a CABG may be recommended if the condition is severe or there is a particularly high risk of serious problems (such as heart attacks) because it is a more effective treatment in these cases.
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