Get helpful tips and guidance for everything from fighting inflammation to finding the best diets for weight loss Stay on top of latest health news from Harvard Medical School. Recent Blog Articles. Why is topical vitamin C important for skin health? Preventing preeclampsia may be as simple as taking an aspirin. Caring for an aging parent? Tips for enjoying holiday meals. A conversation about reducing the harms of social media.
Menopause and memory: Know the facts. How to get your child to put away toys. Is a common pain reliever safe during pregnancy? Can vaping help you quit smoking? Heart Health Bypass or angioplasty with stenting: How do you choose? August 28, Print This Page Click to Print. Top of the page Decision Point.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. This decision is for people who have stable angina and whose doctor has said bypass surgery may be an option for them. Stable angina means that you can usually predict when your symptoms will happen. You probably know what things cause your angina.
For example, you know how much activity usually causes your angina. Bypass surgery—also called coronary artery bypass graft surgery—helps improve blood flow to the heart in people with severe coronary artery disease. In most cases, bypass surgery is open-chest surgery. The surgeon connects, or grafts, a healthy blood vessel from another part of your body to the narrowed coronary artery.
The grafted blood vessel goes around bypasses the narrowed part of the artery. This makes a new path for blood to your heart muscle. Most people have bypasses in two or more arteries. How many you need depends on how many arteries, and which ones, are narrowed.
Bypass surgery is not a cure for heart disease. The surgery doesn't change the way arteries harden or narrow because of heart disease. And it doesn't bypass all the narrowing that you may have in your arteries. Even after surgery, you can still get new places in your arteries that are narrowed. This can happen in the new blood vessels used in the bypass, as well as in the other arteries. If this happens, you may need another surgery or angioplasty with stents.
That's why after surgery you still need medicines and lifestyle changes to give you the best chance of living a longer, healthier life. You will stay in the hospital at least 3 to 8 days after the surgery. You will probably be able to do many of your usual activities after 4 to 6 weeks. Most people are able to go back to work 1 to 2 months after surgery.
You can do things after surgery to help yourself stay healthy and prevent problems. Medicines and a healthy lifestyle—known as medical therapy—can help your bypass grafts last and stay open longer.
Medical therapy also can lower your risk of a heart attack or stroke. You will likely take medicines to prevent blood clots, lower cholesterol, and manage blood pressure. You may need to make lifestyle changes. These include eating right, being active, and not smoking.
It also means losing weight or staying at a healthy weight. A cardiac rehab program can help you make these changes. Surgery isn't right for everyone. Some people can be helped by angioplasty along with medicines and lifestyle changes medical therapy. Others use medical therapy alone. One of these treatments may be an option for you. It depends on your age, your other health problems, and how severe your heart disease is. It also depends on what you want. You and your doctor can decide together whether bypass surgery or another treatment is right for you.
You may have several tests to see if a bypass could help you. You may have had an angiogram that showed your doctor the location and amount of narrowing in your arteries. Your doctor also may have checked how well your heart is pumping blood. Whether a bypass is an option for you depends on several things. These include which coronary arteries are narrowed, your age, and other health problems that you may have.
It also depends on how much your angina keeps you from doing your daily activities and enjoying your life. As you decide about surgery, think about what is most important to you. Talk to your doctor about what you hope surgery could do to improve your symptoms or lengthen your life. The benefits of surgery may or may not outweigh the risks for you. Bypass surgery has been done for more than 40 years. In the United States, it is one of the most common major surgeries.
But it has some risks. The chances of having a serious problem with bypass surgery increase with age. Your risk is also higher if you have other problems such as diabetes, kidney disease, lung disease, or peripheral arterial disease. Your doctor can help you understand what your risk for problems is.
Angina relief: In studies, about 84 out of people who had bypass surgery had angina relief after 1 year. This relief lasted at least 5 years. Living longer: Bypass can help some people live longer. How well bypass might help you live longer depends on several things, including which coronary arteries need to be bypassed and how bad your heart disease is. It also can depend on other conditions that you have, such as diabetes.
Some evidence is better than other evidence. Evidence comes from studies that look at how well treatments and tests work and how safe they are.
For many reasons, some studies are more reliable than others. The better the evidence is—the higher its quality—the more we can trust it. The information shown here is based on the best available evidence. The evidence is rated using four quality levels: high, moderate, borderline, and inconclusive. Another thing to understand is that the evidence can't predict what's going to happen in your case. When evidence tells us that 2 out of people who have a certain test or treatment may have a certain result and that 98 out of may not, there's no way to know if you will be one of the 2 or one of the Take people who have bypass surgery.
Complication rates in hospitals show people face these risks from bypass surgery:. These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. I never thought twice about whether bypass surgery was right for me. These arteries supply your heart with oxygenated blood. This can lead to heart failure.
Your doctor will recommend a certain type of bypass surgery depending on how many of your arteries are blocked. Your risk of having a heart attack , heart failure, or another cardiac issue depends on the number of arteries blocked. Blockage in more arteries also means that the surgery may take longer or become more complex. When a material in your blood called plaque builds up on your arterial walls, less blood flows to the heart muscle.
This type of coronary artery disease CAD is known as atherosclerosis. Atherosclerosis can affect any arteries in the body. Your doctor may recommend heart bypass surgery if your coronary arteries become so narrowed or blocked that you run a high risk of a heart attack.
Your doctor will also recommend bypass surgery when the blockage is too severe to manage with medication or other treatments. A team of doctors, including a cardiologist, identify whether you can undergo open-heart surgery.
Some medical conditions can complicate surgery or eliminate it as a possibility. Discuss these issues with your doctor before scheduling your surgery. Planned surgery outcomes are usually better than emergency surgery. As with any open-heart surgery, heart bypass surgery carries risks. Recent technological advancements have improved the procedure, increasing the chances of a successful surgery.
In the past decade, more alternatives to heart bypass surgery have become available. These include:. During this treatment, a tube is threaded through your blocked artery. Afterward, a small balloon is inflated to widen the artery. The doctor then removes the tube and the balloon. A small metal scaffold, also known as a stent , will be left in place.
A stent keeps the artery from contracting back to its original size. Enhanced external counterpulsation EECP is an outpatient procedure. It can be performed as an alternative to heart bypass surgery, according to multiple studies. EECP involves compressing blood vessels in the lower limbs. This increases blood flow to the heart. After having a coronary artery bypass graft, most people will experience a significant improvement in symptoms such as breathlessness and chest pain , and their heart attack risk will be lowered.
If you don't make lifestyle changes, such as eating a healthy diet and exercising regularly , your grafted arteries will also eventually become hardened and narrowed. In some cases, a coronary artery bypass graft may need to be repeated or you may need a procedure to widen your arteries using a small balloon and a tube called a stent coronary angioplasty.
It's a less invasive operation where a long, flexible, hollow plastic tube called a catheter is inserted into a blood vessel in your arm or groin. 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 used to help keep the artery open.
It usually takes less time to recover from a coronary angioplasty than from a coronary artery bypass graft, but there's a higher chance that the procedure will need to be repeated.
Also, a coronary angioplasty may not be recommended if multiple coronary arteries have become blocked and narrowed or the structure of the blood vessels near your heart is abnormal. The length of time you'll have to wait to have a coronary artery bypass graft will vary from area to area. Your GP or cardiac surgeon should be able to tell you what the waiting lists are like in your area or at the hospital you have chosen.
0コメント