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Angina Pectoris (cont.)

What about surgery for angina?

Like angioplasty, surgery is an option for people whose angina does not improve with medications and others who are at high risk of having a heart attack. Surgery is usually reserved for people with very severe narrowing or blockage in several coronary arteries.

In almost all cases, the operation used for severely narrowed coronary arteries is coronary artery bypass grafting.

Coronary artery bypass surgery

  • The chest and rib cage are opened up (open heart surgery)
  • The narrowed part of the artery is bypassed by a piece of vein removed from the leg, or with a piece of artery behind the sternum (internal mammary artery), or a portion of the radial artery taken from the lower arm or forearm.
  • Several arteries can be bypassed in one operation.
  • This is a very safe operation, with a mortality rate of less than 1%, in people whose heart muscle is not severely damaged irreversibly and who have normal lungs, kidneys, liver, and other organs.
  • Because the chest is opened, the recovery time can be quite long, especially if the person is older and has multiple other health problems.

Do I need to follow-up with my doctor after being diagnosed with angina?

If a person has stable angina, they will need to visit their health-care professional on a regular basis to monitor angina episodes and assess if risk factors are being reduced.

The person's health-care professional will probably test their heart function periodically and assess the underlying disease. These tests will probably include the following:

  • ECG
  • Exercise tolerance tests
  • Thallium stress test
  • Repeat cardiac catheterization to see if the dilated artery or stent is still open and/or a surgical bypass graft is still open or closed. This is the key downside of both angioplasty and surgery: arteries, stents, and grafts restenose (occlude) with the same disease process of atherosclerosis. None of these procedures are a permanent cure. The person has to be very compulsive in correcting potential risk factors, or they will return with the same blockages they started with.
Medically Reviewed by a Doctor on 5/31/2016

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