Open heart vs Angioplasty

[Donna Harrah]

5 yrs ago my husband had angioplasty. Today he has 2 blocked arteries. Tomorrow he will go to hospital to have additional tests done. His doctor told him he maight want to try the angioplastystent if only 2 blockages. He is 58 yrs old, smokes, has high blood pressure and is under a lot of stress. What are comments if any about angioplastystent vs heart surgery?

[Betsy Cramer]

<< Angioplasty vs. heart surgery is a very large topic and there are many excellent reviews.... >>Could you provide, please, sites or references for information on angioplasty? And its alternatives, such as diet, medication? I went to the E.R. the other night ... and after a series of tests yesterday was told that one cardio (right front?) artery is somewhat blocked and that I should have angioplasty. Very uncertain about it -and uncertain, too, whether I ahve insurance coverage for the night/day in the hospital and the second night for the angioplasty, I chose to leave yesterday (with a prescription for 50mg. of atenolol) to find out more about what my options are - other than an operation. Is a second opinion desirable?
Thanks very much.

[Cleveland Clinic, MD]

Angioplasty vs. heart surgery is a very large topic and there are many excellent reviews in the medical literature if you have a special interest in the topic.  In brief however there are 3 situations where bypass surgery has traditionaly been favored over angioplasty: 1) left main artery disease; 2) 3-vessel disease (all the major vessels of the heart) with depressed heart function and ; 3) In diabetics with 3-vessel disease.

There are many other pros and cons to surgery vs. angioplasty which your husband's doctor can discuss with you.  In general the trend is going to more angioplasty and less surgery, particularlly with newer medications and stents.  Of course he should also be doing things to reduce his risk of the blockages progressing such as stopping smoking and controlling his blood pressure.  Best wishes to you.