Surgical and Other Invasive Procedures for Heart Attack

Coronary Artery Bypass Grafting (CABG)

During CABG, a healthy blood vessel is taken from somewhere in the body. The healthy blood vessel is attached to an artery in the heart just above and below the blockage. The new blood vessel lets blood move around the blockage. Bypass can be done for each blocked artery in the heart. CABG can be done as:

• On-pump—Done while the heart is stopped. A machine moves blood and oxygen around the body for the heart and lungs. Once the arteries are fixed, the heart is restarted.
• Off-pump—No machine is needed. The arteries are fixed while the heart is beating.
• Minimally invasive direct—Small cuts are made along the left side of the chest and between the ribs to get to the blood vessels.

Angioplasty

A catheter is threaded through an artery in the groin and passed to the problem artery. Imaging tracks the catheter and watches blood flow.

Types of angioplasty are:

• Balloon—The catheter is placed in the near-blocked artery. A small balloon is quickly inflated and deflated. This lets the balloon press the plaque on the walls of the artery to open reopen it. The catheter is taken out when blood flow returns to normal.
• Stent—A mesh stent may be placed in the artery to keep it open. The stent may be coated with medicine to keep it from narrowing again.
• Laser—A laser beam vaporizes the plaque to open the artery.
• Atherectomy—A shaver on the tip of the guided catheter slices the plaque away.