Information for the public
Procedures to improve blood flow to the heart
Procedures to improve blood flow to the heart
If you think that your care does not match what is described in this information, please talk to a member of your healthcare team in the first instance.
If your symptoms do not respond to drug treatment
Your healthcare professional may offer you one of the following procedures to help increase blood flow to the heart and relieve your symptoms:
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using surgery to bypass the narrowed artery (known as coronary artery bypass grafting or CABG)
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a procedure that stretches and holds open the narrowed part of the artery (called percutaneous coronary intervention or PCI).
Your healthcare professional may offer you tests (see box below: 'What tests should I be offered to help decide which procedure is best for me?') to help decide which procedure is most appropriate for you. They will consider the risks and benefits of each procedure or of continuing drug treatment, taking into account any other medical conditions such as diabetes, the extent of your heart disease, the structure of the blood vessels around your heart, your age and the severity of your symptoms.
If your symptoms do respond to drug treatment
If your symptoms do respond to drug treatment, your healthcare professional should talk with you about the possibility that you may need further treatment for your heart disease. They may offer you tests (see box below: 'What tests should I be offered to help decide which procedure is best for me?') to assess the extent of your heart disease and to see whether having CABG to increase the blood flow to your heart would help you in the long term. Your healthcare professional will consider the risks and benefits of CABG or of continuing drug treatment.
Deciding about tests and procedures
The risks, benefits and limitations of having each test and procedure, or of continuing with drug treatment, will be discussed with you. Your healthcare professional will explain what each test and procedure involves, including how long you may need to spend in hospital, how long it could take to recover and any drug treatment you may need after the procedure. They will ensure that you have balanced information about your options to help you make an informed decision.
What tests should I be offered to help decide which procedure is best for me?
You may be offered one or more of the following tests:
Invasive coronary angiography uses X-rays to see how dye (called contrast medium) moves through the arteries up to the heart. This shows whether there are any narrowed or blocked arteries. It is invasive because it involves a fine, hollow tube called a catheter being inserted through the artery of the person's leg or arm and up to the heart.
CT coronary angiography uses a type of X-ray called computed tomography (CT) scanning and dye injected into the person's veins to show whether the coronary arteries are narrowed or blocked.
Functional imaging tests show how the heart works under stress. Different tests can be used depending on the circumstances and the person's preferences.
Questions you might like to ask about the procedures
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What does each procedure involve?
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Is one procedure more effective in relieving symptoms than the other?
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Which is the best procedure for me?
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What are the possible complications of the procedure?
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How long will I have to stay in hospital?
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Will I have to take drugs after the procedure?
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Am I likely to need another procedure in the future?
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What could happen if I choose not to have the recommended procedure?