- With Mayo Clinic cardiologist
Martha Grogan, M.D.
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Martha Grogan, M.D.
Martha Grogan, M.D.
Dr. Martha Grogan is board-certified in internal medicine and cardiovascular diseases. She is a native of Cincinnati, Ohio, and received her medical degree from Northwestern University Medical School. Dr. Grogan has been on staff at Mayo Clinic since 1995 and is a consultant in the Division of Cardiovascular Diseases and is an assistant professor of medicine at Mayo Medical School.
Dr. Grogan is a noninvasive cardiologist specializing in heart failure, adult congenital heart disease and echocardiography. She has witnessed firsthand the importance of patient education in the treatment of diseases such as congestive heart failure and is excited about the tremendous educational opportunities now available through the Internet.
Risk factors (1)
- CRP level: A risk factor for heart disease?
Complications (1)
- Cardiac ischemia
Treatments and drugs (3)
- Arthritis pain medications: Do they raise blood pressure?
- Cardiac stents: Can they be replaced if blockage recurs?
- Coronary artery disease: Angioplasty or bypass surgery?
Lifestyle and home remedies (1)
- Grass-fed beef: What are the heart-health benefits?
Prevention (1)
- Can vitamins help prevent a heart attack?
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Question
Coronary artery disease: Angioplasty or bypass surgery?
My doctor has scheduled a cardiac catheterization. If blockages are found, what factors determine whether angioplasty or bypass surgery is most appropriate?
Answer
from Martha Grogan, M.D.
During cardiac catheterization, your doctor will examine images of the inside of your coronary arteries. If cholesterol plaques in these arteries (coronary artery disease) have caused areas of narrowing, treatment options depend on various factors, including:
- Severity and extent of coronary artery disease
- Symptoms, such as chest pain and shortness of breath
- Overall heart function
- Other medical conditions, such as heart valve disease, diabetes, kidney disease, peripheral artery disease, or prior stroke or heart attack
For some people, medications and lifestyle changes may be the treatment of choice — especially if only one artery is affected.
In other cases, coronary angioplasty may be recommended to open the clogged arteries — especially if blood flow to the heart is reduced while you're at rest. During angioplasty, a tiny balloon is inserted and expanded at the site of the blockage to widen the narrowed artery. Typically, a small metal coil called a stent is implanted in the clogged artery to help prop the artery open and reduce the risk of it narrowing again.
If your arteries are narrowed or blocked in multiple areas, coronary bypass surgery may be necessary. Specific factors that affect the decision to recommend bypass surgery include the location of the blockages, the presence or absence of diabetes, and your heart function. During bypass surgery, a section of healthy blood vessel — often taken from inside the chest wall or the lower leg — is attached above and below the blocked artery. This allows blood to bypass the blocked area and flow to the heart muscle.
It's important to note that some types of narrowing are more difficult to treat than are others. For example, people who have severe narrowing of very small blood vessels may not benefit from either angioplasty or bypass surgery. In such cases, medication may be the only treatment option.
The treatment of coronary artery disease is individualized. The information from your cardiac catheterization will help you and your doctor determine which treatment option is best for you.
Next questionGrass-fed beef: What are the heart-health benefits?
- Cutlip D, et al. Bypass surgery versus percutaneous intervention in the management of stable angina pectoris: Recommendations. http://www.uptodate.com/home/index.html. Accessed Aug. 25, 2008.
- Levin T, et al. Medical versus interventional therapy in the management of stable angina pectoris. http://www.uptodate.com/home/index.html. Accessed Aug. 25, 2008.
