Angioplasty or bypass surgery: Which treatment is best to treat coronary artery disease?

Coronary artery disease (CAD) is a condition that affects millions of people worldwide. It occurs when the arteries that supply blood to the heart become narrowed or blocked due to the buildup of plaque. This can lead to chest pain, shortness of breath, and other symptoms. Two common treatments for CAD are angioplasty and bypass surgery. Both procedures aim to improve blood flow to the heart, but they differ in their approach and benefits. Both have their pros and cons and which one is best for a particular patient depends on several factors.

Pros and cons of angioplasty

Health Shots reached out to Dr Nishith Chandra, DM, FACC, Principal Director, Interventional Cardiology, Fortis Escorts Heart Institute, Delhi. He explained to us that angioplasty is a minimally invasive procedure that involves inserting a catheter into the blocked artery and inflating a small balloon to widen the artery. This is followed by inserting a stent to keep the artery open. “Angioplasty is less invasive, and recovery time is typically faster. However, the long-term effectiveness of angioplasty depends on the location and severity of the blockage,” says Dr Chandra.

Here are some of the pros and cons of angioplasty:

Pros

1. It is less invasive than bypass surgery, which means there is less pain and a faster recovery time.
2. It is often performed on an outpatient basis, which means the patient can go home the same day.
3. The risk of complications is generally lower than with bypass surgery.
4. It can be an effective treatment for single or double artery blockages.

Cons

1. It may not be suitable for patients with multiple or complex blockages.
2. The artery can become blocked again over time, requiring additional procedures.
3. The patient may need to take medication to prevent blood clots or lower cholesterol levels.
4. There is a risk of complications such as bleeding, infection, or damage to the artery.

Pros and cons of bypass surgery

The Cardiologist explains that bypass surgery is a major surgical procedure that involves creating a new pathway for blood to flow around the blocked artery. The surgeon grafts a blood vessel from another part of the body to bypass the blocked area. “Bypass surgery is more effective than angioplasty in patients with multiple blockages or blockages in larger arteries. However, it is a more invasive procedure with a longer recovery time,” says Dr Chandra.

Pros

1. It can be an effective treatment for multiple or complex blockages.
2. The new blood vessel can last for many years, providing long-term benefits for the patient.
3. It can reduce the risk of a heart attack, especially in patients with severe blockages.

Cons

1. Carries risks such as bleeding, infection, and complications related to anesthesia.
2. Recovery from bypass surgery can be a lengthy process, and patients may require several weeks or months of rehabilitation.
3. There is a small risk of complications related to the new blood vessel, such as blockages or leaks.

Also read: Give your heart some extra care post cardiac surgery to avoid complications

Angioplasty vs bypass surgery

Dr Chandra explains that both procedures have risks, including bleeding, infection, and damage to surrounding organs. However, bypass surgery has a slightly higher risk of complications, such as stroke or heart attack. Angioplasty is typically done on an outpatient basis, while bypass surgery requires a hospital stay.

In summary, the choice between angioplasty and bypass surgery depends on the patient’s individual circumstances, including the location and severity of the blockage, the patient’s overall health, and the patient’s preference. Angioplasty is less invasive with a shorter recovery time, while bypass surgery is more effective in patients with multiple blockages or larger arteries. Ultimately, the decision should be made in consultation with the patient’s cardiologist and a cardiac surgeon.