Angioplasty or Bypass Surgery?Which is better for you?

Aug 26, 2023

Angioplasty or Bypass Surgery?Which is better for you?

Angioplasty or Bypass Surgery ? Which is better for you

ஆஞ்சியோப்ளாஸ்ட்டி யாருக்கு? பைபாஸ் ஆபரேசன் யாருக்கு?

# angioplasty # bypass surgery # CABG # heart attack # heart catheterisation procedure # angiogram procedure # angioplasty procedure
# health videos tamil # health awareness # health tips tamil 2023 # hypertension # diabetes # obesity

Previous Videos

1.Why Young People are dying of Heart attack?
• Why young people are dying of heart a… 2.
2. Don’t Ignore Chest pain - It could be a Heart attack
• Don’t Ignore Chest Pain - It Could Be…

Chapters/ Time code

00:00 Introduction
00:56 Angiography
02:04 Angioplasty
03:14 Bypass Surgery or CABG
03:48 Who needs Angioplasty. Who needs CABG. How experts decide?
05:08 Conclusion

Who needs coronary angioplasty ?Who needs CABG - Bypass Surgery ?

If the blood vessels supplying heart - that is coronary arteries- get blocked significantly, patients develop heart attack ( myocardial infarction). There are two types of treatment modalities available to relieve the block and reestablish the blood flow. One is, coronary angioplasty. The other one is CABG - commonly known as Bypass surgery. Common public often get confused why someone is chosen for angioplasty or CABG.

So in this video I am trying to explain in a simple language about
- coronary angiography
- coronary angioplasty
- CABG
- scientific reasons behind selecting one modality over the other.

1. Coronary Angiography

This is an imaging technique to understand the details of coronary artery. To do the procedure a small plastic catheter is inserted through patients femoral artery or radial artery. Then it is slowly advanced towards heart. Once it enters the origin of coronary artery radio opaque contrast material is injected. Serial x rays are taken. Which gives the details of all the coronary arteries and the blocks.
Sometimes angioplasty is also done at the same sitting.

2. Coronary Angioplasty

During this procedure, similar to coronary angiogram, a small plastic catheter is inserted through femoral artery or radial artery. This catheter has a small balloon at the tip. Then the catheter is slowly advanced towards heart. Once it reaches heart - coronary arteries- the catheter is pushed further towards the blocked artery. Once the catheter bypasses the blocked portion of the artery the balloon is inflated. The atherosclerotic plaque is pushed towards vessel wall by the balloon and the block is relieved. Blood flow is reestablished. This is called balloon angioplasty.

Then a small stent - metallic mesh- is placed there to prevent re occlusion.

This procedure is relatively simpler compared to CABG. Patients don’t need anaesthesia or surgery. Recovery is also faster.

3.CABG or Bypass surgery

This is a major surgery. Often requires opening the chest by sternotomy.

Grafts are taken commonly from saphenous vein and internal mammary artery. The grafts are used to bypass the blocked coronary segments.

4. How to decide who needs angioplasty and who needs CABG?

Heart is supplied by three major coronary vessels. Among that left anterior descending artery( LAD)is considered the most important because it supplies major portions of left ventricle( of heart).

When one or two coronary arteries are blocked coronary angioplasty is preferred. But when all the three vessels are involved CABG is preferred.

In addition, patients with diabetes, heart failure or patients with significant left main coronary artery disease, CABG has shown better outcomes - in studies.

Sometimes angioplasty becomes difficult or impossible. For example when the vessel is fully blocked if there are no space for catheter to pass through or when the coronary arteries are calcified. Sometimes the block might be in a tricky anatomical location making it difficult for angioplasty. So all these cases CABG would be the only option.

In most of the institutions the decision will be taken by a team of doctors which consists of cardiologist and CTVS surgeon. All the factors would be considered before taking the decision. Family also would be encouraged to take part in the decision making.

Thanks.

Content

0.24 -> Hello In the previous video we have seen in details of Heart attack. When the blood vessels supplying heart ( coronary arteries) gets blocked significantly, that results in Heart attack.

8.22 -> There are two treatment modalities to remove the block - to re establish the blood flow. 1. Coronary Angioplasty 2. CABG or Bypass surgery

25.56 -> Common public often get confused. why someone undergoes Coronary Angioplasty or Bypass surgery.

26.957 -> How the experts choose between these two?

27.56 ->

32.918 -> So What is Coronary Angioplasty?

34.918 -> What Is Coronary Angioplasty?

36.918 -> What is CABG or Bypass Surgery?

37.418 ->

39.418 -> How experts decide between these two treatment modalities.

41.418 ->

46.983 -> Join me to see the details.

48.983 -> I am Dr Buddhan Rajarathinam

50.983 ->

51.54 -> Welcome to my Youtube channel

53.54 ->

55.579 ->

57.579 -> We will see first the details of coronary angioplasty.

59.579 -> This is an imaging technique.

60.079 -> This is done to see the details of the coronary arteries

63.092 ->

65.092 ->

66.802 -> This imaging test plays a significant role in decision making whether someone would benefit from angioplasty or CABG

72.06 -> During the procedure a small plastic catheter is inserted through femoral artery or radial artery

79.8 ->

81.8 -> That catheter would be slowly pushed towards heart.

86.801 ->

89.677 -> When it reaches the origin of coronary arteries

91.677 -> a contrast material would be injected.

92.586 ->

94.784 -> This radio opaque. Would be visible on x rays.

96.784 ->

99.569 -> The contrast would mix with blood and flow through the coronary arteries.

101.88 -> Then x rays would be taken. Those images would identify the details - where is the block/ how many blocks are there.

114.42 ->

116.42 ->

117.493 -> Sometimes angioplasty also would be combined with this.

119.493 ->

122.616 -> Next Coronary Angioplasty

124.616 -> Same like angiography procedure here also a small catheter ( balloon tipped)

126.217 ->

131.722 -> would be inserted through femoral artery or radial artery

133.722 ->

135.722 ->

137.722 -> Then pushed towards heart.

139.722 ->

140.547 -> Here the catheter would be further pushed towards the blocked artery.

142.547 ->

147.058 -> Just beyond the block.

149.058 ->

150.268 -> There is a small balloon at the tip of the catheter.

152.268 ->

153.69 -> The balloon is just positioned exactly at the site of blockade

155.69 ->

157.658 -> the balloon is inflated.

159.658 -> So the lipid plaque would be pushed towards the wall

160.82 ->

164.689 -> free blood flow is re established.

166.689 ->

167.705 -> This is called balloon angioplasty.

169.705 ->

171.412 -> Then a small metallic stent would placed to prevent vessel collapse or restenosis.

182.1 -> Compared to CABG this is simpler. Recovery also faster.

188.22 ->

188.76 ->

195.336 -> Next CABG or Bypass surgery

197.336 -> This is a major surgery.

198.768 ->

203.876 -> For this procedure surgeons harvest grafts from saphenous vain or internal mammary artery or from both

205.876 ->

212.271 -> Using these grafts the blocked portion of the coronary arteries are bypassed.

218.4 -> You can understand by seeing the picture. The graft helps to bypass the block and re establish the blood flow.

227.34 -> This is Bypass surgery.

227.84 ->

229.166 -> Let us discuss about the important question.

231.166 -> Who needs Angioplasty? Who needs Bypass surgery?

235.166 -> Heart is supplied by three important coronary arteries

237.166 -> Among that Left Anterior Descending artery is very important one.

239.166 ->

241.166 -> If one or two vessels are blocked angioplasty is preferred. If all three vessels are blocked CABG is preferred.

267.36 -> Sometimes angioplasty would be difficult because of calcified or fully blocked vessel. Catheter can not pass through. Sometimes the block might be at bifurcation making the plasty technically difficult.

287.3 ->

289.3 ->

309.39 -> In most of the hospitals a team of doctors - cardiologists, CTVS surgeons -