Angioplasty or bypass? Understanding your options

What angioplasty involves

In angioplasty (PCI), a thin tube is passed from the wrist or groin to the heart. A small balloon opens the narrowed artery and a metal mesh stent keeps it open. Most patients go home within one to two days and return to light activity within a week.

What bypass surgery involves

Coronary artery bypass grafting (CABG) is open-heart surgery. The surgeon uses blood vessels from the chest, arm or leg to create new paths for blood around the blockages. Hospital stay is usually five to seven days, with full recovery over six to twelve weeks.

Which is right for you?

Angioplasty is often preferred for one or two blockages in easily reachable areas. Bypass is usually recommended when the main left artery is involved, when three vessels are blocked, when the heart's pumping is weak, or in diabetics with widespread disease.

Good centres discuss complex cases in a 'heart team' meeting where a cardiologist and a cardiac surgeon review the angiography together.

Questions to ask your doctor

Before agreeing to any procedure, it is reasonable to ask questions and, if needed, seek a second opinion.

• How many arteries are blocked, and how severely?
• What are the benefits and risks of each option in my case?
• How many of these procedures does your team perform each year?
• What will recovery and follow-up look like?
• What medicines will I need afterwards, and for how long?