NurseReview.Org Angioplasty Vs. Bypass

COLLEGE OF NURSING CABANATUAN CITY WESLEYAN UNIVERSITY – PHILIPPINES

ANGIOPLASTY VS. BYPASS SURGERY

ANATOMY AND PHYSIOLOGY

ANGIOPLASTY

Percutaneous coronary intervention (PCI). or

Percutaneous Transluminal Coronary Angioplasty

ATHEROSCLEROSIS

Cardiac catheterization

Why It Is Done

Frequent or severe chest pain (angina) that is not responding to medication.

Evidence of severely reduced blood flow (ischemia) to an area of heart muscle caused by one or more narrowed coronary arteries.

An artery that is likely to be treated successfully with angioplasty whether or not stenting is also used.

You are in good enough health to undergo the procedure

STENTS

A small, expandable wire tube is often permanently inserted into the artery during angioplasty.

Balloon angioplasty

Stenting should:

Open up the artery and press the plaque against the artery's walls, thereby improving blood flow.

Keep the artery open after the balloon is deflated and removed.

Seal any tears in the artery wall.

Prevent the artery wall from collapsing or closing off again (restenosis).

Prevent small pieces of plaque from breaking off, which might cause a heart attack.

Coronary angioplasty: Blockage in a coronary artery

Coronary angioplasty: Step 1

Coronary angioplasty: Final

How Well It Works Angioplasty relieves chest pain and improves blood flow to the heart. If restenosis occurs, another angioplasty or bypass surgery may be needed.

Coated stents

Intracoronary radiotherapy

Rotational atherectomy

Stents:

RISKS:

Bleeding at the puncture site.

Sudden closure of the artery.

Heart attack.

Need for additional procedures. Angioplasty may increase the risk of needing urgent bypass surgery. In addition, the repaired artery can renarrow (restenosis) and a repeat angioplasty may need to be performed.

Reclosure of the grafted blood vessel (restenosis).

Death. The risk of death is higher when more than one artery is involved.

BYPASS

CABG- coronary artery bypass graft

-To improve the blood flow to the myocardial tissue

How is coronary bypass done?

Surgeons take a segment of a healthy blood vessel from another part of the body and make a detour around the blocked part of the coronary artery.

An artery may be detached from the chest wall and the open end attached to the coronary artery below the blocked area.

A piece of a long vein in your leg may be taken. One end is sewn onto the large artery leaving your heart -- the aorta. The other end of the vein is attached or "grafted" to the coronary artery below the blocked area.