Heart Surgery and Other Invasive Procedures

An invasive procedure is one in which your doctor uses instruments or surgical tools to diagnose or treat you. Two main invasive procedures can be used to treat CHD. One of them requires surgery. The two procedures are angioplasty, with or without a stent, and coronary bypass surgery.

How will my doctor decide if I need an angioplasty or surgery?

To help decide if you need angioplasty versus surgery, your doctor will likely want to do a cardiac catheterization. This is an invasive procedure itself. A cardiac catheterization allows a doctor to see how well blood is flowing through the major arteries in your heart. It is a diagnostic procedure to see what is wrong and where problems are. Once your doctor uses the cardiac catheterization to find out how much artery blockage you have, he or she can then decide what kind of treatment you will need.


How is cardiac catheterization done?

The first step is for you to receive a local anesthetic so you don't feel any pain. Other medicine is given to you so that you become relaxed and sleepy.

Then, in either your arm or your groin, your doctor makes an incision and inserts a small needle into a blood vessel. Next, your doctor feeds a thin wire into your blood vessel. Over this thin wire is a flexible catheter. The catheter is fed up to the heart.

To see how to guide the catheter through your artery, your doctor uses an X-ray camera called a fluoroscope. This camera projects an image onto a TV screen. When the catheter has reached the coronary artery, the doctor injects dye through this catheter into the artery.

The dye enables your doctor to watch the blood flow through the vessels that surround your heart. That way, your doctor can see any places where the blood flow is narrowed or where the arteries are blocked by plaque. If the doctor finds blocked areas, he or she may perform an angioplasty.

What happens after the cardiac catheterization?

If your doctor decides that angioplasty is the right course of treatment for you, he or she may do it right then. See How Is Angioplasty Done? to read more about this procedure.

If your doctor decides that coronary bypass surgery is the better course of treatment for you, he or she will help you set up a plan for that to happen. See what do I need to know about coronary artery bypass surgery? to read more about what to expect from surgery.

For an overview of the two alternatives to invasive treatment for CHD, keep reading.

Comparing the Main Invasive Treatments for CHD

Angioplasty Coronary Bypass Surgery minor surgery (fewer risks) major surgery (greater risks) costs less than bypass costs more than angioplasty length of procedure is 30 minutes to 2 hours length of procedure is 3 to 6 hours local anesthesia (less risk) general anesthesia (greater risk) shorter hospital stay (1 to 3 days) longer hospital stay (4 to 7 days) short recovery time lengthy recovery time (several weeks) may need to be repeated within 6 months results usually last longer than with angioplasty


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