A stent is a tiny wire mesh tube that is used to prop open an artery. A stent is commonly used along with angioplasty and/or plaque removal. In this procedure, a stent is placed over a balloon catheter and then moved into the area of the blockage. When the balloon is inflated, the stent expands and locks into place, holding open the artery. The stent remains in the artery permanently, improving blood flow to the heart muscle and relieving chest pain.
A stent reduces the chances that an artery will narrow again after an angioplasty and/or plaque removal. Newer types of stents are coated with medication that is slowly released and helps to keep the blood vessel from closing up again.
Stenting may be particularly beneficial for women. In a large study of heart attack patients, women who received a stent were less likely to suffer a major heart complication during the following year, and also less likely to need a repeat procedure than those who received balloon angioplasty without stenting.
Coronary Bypass Surgery
Open heart bypass surgery is often chosen when artery blockages are hard to reach or are too extensive for angioplasty. In this procedure, the surgeon takes a piece of blood vessel from the leg or chest and then attaches it to the heart artery both above and below the narrowed area. This procedure creates a new route, or "bypass," around the blockage. Afterward, the blood can use this new pathway to flow freely to the heart muscle, thereby reducing the risk of a heart attack. In some cases, more than one bypass is necessary.
For most operations, the patient is connected to a heart-lung machine that delivers oxygen to the blood and circulates it throughout the body so that the heart can be temporarily stopped while the bypass is made. When the surgery is finished, the heart is restarted. A person who undergoes bypass surgery usually stays in the hospital for about a week, and then continues to recuperate for several weeks at home.
Two recently developed types of bypass surgery do not require use of the heart-lung machine. These include off-pump bypass surgery (see Beating Heart Bypass Surgery) and minimally invasive coronary artery bypass.