If lifestyle changes and drug therapy do not help control angina pectoris, then surgery may be necessary. The aim of surgery is to increase the blood flow to the heart by physically opening up the narrowed coronary artery. The most commonly used surgical procedures are coronary angioplasty and coronary artery bypass grafting (heart bypass). Coronary angioplasty involves inserting a long, thin tube known as a catheter into an artery in the arm or leg and then guiding it up and into the affected coronary artery. A second catheter with a balloon at the tip is then inserted and guided to the blocked or narrowed artery and inflated to remove the blockage in the artery. Often, a tiny metal tube known as a stent is inserted to help hold the artery open. Coronary angioplasty is a minimally invasive procedure and done under local anesthetic. Other names for coronary angioplasty include percutaneous coronary intervention, percutaneous transluminal coronary angioplasty, or balloon angioplasty. Also known as a heart bypass, coronary artery bypass surgery is used to re-route the blood supply around a narrowed or blocked artery using a vein from the leg or an artery in the chest. The number of bypasses performed will depend on how many coronary arteries are blocked or narrowed. Coronary artery bypass surgery is a major operation done under general anesthetic.
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