Procedures,
such as cardiac bypass surgery can hugely benefit heart disease patients by
opening blocked arteries and improving blood flow through the heart.
Unfortunately, some patients are considered too “high risk” for such measures,
and there are few alternatives to mitigate their symptoms. This is where
cardiac revascularization comes into play. Risk of having a heart attack
increases when coronary artery disease has narrowed one of your arteries by 70
percent.
Selecting the
best revascularization procedure is essential. Doctors recommend percutaenous
coronary intervention, or PCI (a minimally invasive procedure to open arteries
by threading a catheter through the leg and into the heart to open blockage
with a balloon-like device or by deploying a stent in the artery) if there is
one or two lesions threatening to cause a heart attack, whereas coronary artery
bypass grafting (CABG) is advised in case severe atherosclerosis was present
throughout the left anterior descending (LAD) artery and other arteries in your
ticker. According to cardiologists, CABG and PCI don’t have the same long-term
impact. When it comes to CABG, it not only keeps the culprit lesion from
causing a heart attack, but also protects against future events caused by
lesions that may form in the same artery. On the other hand, stents cannot
protect against future lesions, which means they cannot protect against future
heart attacks.
Significance of Revascularization:
1.
Treatment of high-risk patients is now possible in view to several
medical advances and treatments, which include medical therapies, surgery, and
percutaneous coronary revascularization. Heart transplantation is recommended
for patients with the most severe conditions, or patients may be put on
left-ventricular assist devices.
2.
Atherosclerosis is the main reason behind coronary artery disease,
when fatty plaques accumulate inside your artery walls, which can narrow down a
vessel to the extent that blood can no longer pass through it. Plaques can also
rupture, spilling their contents into the artery and causing formation of a
blood clot that can disrupt blood flow, which eventually results in a heart
attack. The area of heart muscle that’s nourished by the affected artery is
starved of oxygen and can die when heart attack takes place. Revascularization-
with either CABG or PCI- restores adequate flow of freshly oxygenated blood to
these areas.
Which option is better- CABG or PCI?
How you’ll
benefit from revascularization completely depends on how extensive your disease
is. CABG can increase the lifespan of someone who has significant disease
throughout their coronary arteries. The higher the extent of your disease, the
more significantly you can benefit from CABG. Talking about PCI, it focuses on
treating severe lesions that limit blood flow, which makes it the most
appropriate when a single blockage is causing a heart attack. But PCI only
addresses a single lesion in comparison to CABG that addresses most
heart-attack causing lesions occurring in the upper one-third of the artery.
There are times
when an individual’s overall condition, such as when they have another existing
condition like severe lung disease, liver disease, extreme age, etc. - makes
PCI a safer choice too, since in these cases risk associated with surgery is
higher than the risk of heart attack. It’s always advisable to look beyond the
immediate effect of treatment and look forward to its long-term impact.
You must know
that not all CABGs are created equal, undergo treatment always in consultation
with your doctor.
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