Angiography/Angioplasty

Updated:Aug 13,2012

Senior Couple In Hospital With DoctorIf you've had a heart attack, you may have already had certain procedures to help you survive your heart attack and diagnose your condition. For example, many heart attack patients have undergone thrombolysis, a procedure that involves injecting a clot-dissolving agent to restore blood flow in a coronary artery. This procedure is administered within a few (usually three) hours of a heart attack. If this treatment isn't done immediately after a heart attack, many patients will need to undergo coronary angioplasty or coronary artery bypass graft surgery (CABG) later to improve blood supply to the heart muscle.

See Diagnostic Tests and Procedures At-A-Glance to better understand the tests you may have to undergo to find out if you had a heart attack, how much damage was done and what degree of coronary artery disease (CAD) you have.

Cardiac Procedures and Surgeries

Angioplasty

(Also known as Percutaneous Coronary Interventions [PCI], Balloon Angioplasty and Coronary Artery Balloon Dilation)
 

What the Procedure Does
Special tubing with an attached deflated balloon is threaded up to the coronary arteries. The balloon Is inflated to widen blocked areas where blood flow to the heart muscle has been reduced or cutoff. Often combined with implantation of a stent to help prop the artery open and decrease the chance of another blockage. Considered less invasive because the body is not cut open. Lasts from 30 minutes to several hours. Often requires an overnight hospital stay.


Reason for the Procedure

  • Greatly increases blood flow through the blocked artery.
  • Decreases chest pain (angina).
  • Increases ability for physical activity.
  • Reduces risk of a heart attack.
  • Can also be used to open neck and brain arteries to help prevent stroke. 

Angioplasty, Laser

What the Procedure Does
Similar to angioplasty except that the catheter has a laser tip that opens the blocked artery. Pulsating beams of light vaporize the plaque buildup.


Reason for the Procedure

  • Increases blood flow through blocked arteries. 

Artificial Heart Valve Surgery

(Also known as Heart Valve Replacement Surgery)


What the Procedure Does
Replaces an abnormal or diseased heart valve with a healthy one.


Reason for the Procedure

  • Restores function of the heart valves. 

Atherectomy

What the Procedure Does
Similar to angioplasty except that the catheter has a rotating shaver on its tip to cut away plaque from the artery.


Reason for the Procedure

  • Increases blood flow through the blocked artery by removing plaque buildup.
  • May also be used in carotid arteries (major arteries of the neck leading to the brain) to remove plaque and reduce risk for stroke. 

Bypass Surgery

(Also known as CABG or "cabbage," Coronary Artery Bypass Graft and Open-Heart Surgery)
 

What the Procedure Does
Treats blocked heart arteries by creating new passages for blood to flow to your heart muscle. It works by taking arteries or veins from other parts of your body — called grafts — and using them to reroute the blood around the clogged artery. A patient may undergo one, two, three or more bypass grafts, depending on how many coronary arteries are blocked. Requires several days in the hospital.


Reason for the Procedure

  • One of the most common and effective procedures to manage blockage of blood to the heart muscle.
  • Improves the supply of blood and oxygen to the heart.
  • Relieves chest pain (angina).
  • Reduces risk of heart attack.
  • Improves ability for physical activity.

Cardiomyoplasty

What the Procedure Does
An experimental procedure in which skeletal muscles are taken from a patient's back or abdomen. Then they're wrapped around an ailing heart. This added muscle, aided by ongoing stimulation from a device similar to a pacemaker, may boost the heart's pumping motion.


Reason for the Procedure

  • Increases the pumping motion of the heart.

Heart Transplant

What the Procedure Does
Removes a diseased heart and replaces it with a healthy human heart when a heart is irreversibly damaged. Uses hearts from organ donation.


Reason for the Procedure

  • Recognized as a proven procedure to restore heart health in appropriately selected patients. 

Minimally Invasive Heart Surgery

(Also known as Limited Access Coronary Artery Surgery and includes Port-Access Coronary Artery Bypass (PACAB or PortCAB) and Minimally Invasive Coronary Artery Bypass Graft (MIDCAB)


What the Procedure Does
An alternative to standard bypass surgery (CABG). Small incisions ("ports") are made in the chest. Chest arteries or veins from your leg are attached to the heart to "bypass" the clogged coronary artery or arteries. The instruments are passed through the ports to perform the bypasses. The surgeon views these operations on video monitors rather than directly. In PACAB, the heart is stopped and blood is pumped through an oxygenator or "heart-lung" machine. MIDCAB is used to avoid the heart-lung machine. It's done while the heart is still beating. Requires several days in the hospital.


Reason for the Procedure

  • Manages blockage of blood flow to the heart and improves the supply of blood and oxygen to the heart.
  • Relieves chest pain (angina).
  • Reduces risk of heart attack.
  • Improves ability for physical activity. 

Radiofrequency Ablation

(Also known as Catheter Ablation)


What the Procedure Does
A catheter with an electrode at its tip is guided through the veins to the heart muscle with real-time, moving X-rays (fluoroscopy) displayed on a video screen. The catheter is placed at the exact site inside the heart where cells give off the electrical signals that stimulate the abnormal heart rhythm. Then a mild, painless radiofrequency energy (similar to microwave heat) is transmitted to the pathway. This destroys carefully selected heart muscle cells in a very small area (about 1/5 of an inch).


Reason for the Procedure

  • Preferred treatment for many types of rapid heartbeats (arrhythmias) especially supraventricular tachyarrhythmias. 

Stent Procedure

What the Procedure Does
A stent is a wire mesh tube used to prop open an artery during angioplasty. The stent stays in the artery permanently.


Reason for the Procedure

  • Holds the artery open.
  • Improves blood flow to the heart muscle.
  • Relieves chest pain (angina). 

Transmyocardial Revascularization (TMR)

What the Procedure Does
An incision is made on the left breast to expose the heart. Then, a laser is used to drill a series of holes from the outside of the heart into the heart's pumping chamber. In some patients TMR is combined with bypass surgery. In those cases an incision through the breastbone is used for the bypass. Usually requires a hospital stay.


Reason for the Procedure

  • Used to relieve severe chest pain (angina) in very ill patients who aren't candidates for bypass surgery or angioplasty.

Related Information:


Heart Attack