Harvard Health Letter

Bypass vs. angioplasty

Comparisons have produced mixed results, but the heyday for both procedures (especially bypass) may be winding down.

Yes, it's an oversimplification, but at one level, coronary artery disease is a plumbing problem. The coronary arteries supply the heart with blood. When they get gunked up with atherosclerotic plaque, not enough blood can get through. If the blockage isn't too bad, the result is angina, the pain caused by a heart working with an inadequate blood supply. If the blockage is bigger or the plaque ruptures, the result can be a heart attack, the death of heart tissue that was suddenly starved for blood and oxygen.

In the early 1970s, heart surgeons came up with the coronary artery bypass graft as one way to repair coronary artery plumbing. The operation restores blood flow to the heart by taking a section of vein or artery from elsewhere in the patient's body and sewing it to a coronary artery downstream of a blockage.

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