Stents vs. CABG for Heart Attack

There are two ways to clear blocked arteries that cause heart attacks - cardiac stent or coronary artery bypass graft (CABG).

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Stent vs CABG

Helpful Highlights

As a caregiver, you can support your loved one by learning as much as possible about the coronary vessels that are blocked and what was - or is going to be - done about it. Help them, as well as yourself, by going with your loved one to all provider appointments.  Many times, the information is so overwhelming that they will not remember some key points discussed and will hesitate to ask questions. With both of you listening, you’ll be able to prompt them to ask questions during the visit, as well as help them remember what the provider said.  With greater knowledge about the condition, the procedure, and the recommendations, you will be able to provide total support for your loved one.

Stent vs. coronary artery bypass graft (CABG or "bypass")

Which is best? It’s not a toss-up, but the right choice depends on several factors, and this question actually has a (general) answer – bypass (CABG) – provided your loved one's surgery risk isn’t too high.

Why?

The question of stent versus bypass (CABG) is really for those who have multi-vessel disease involving the three main coronary arteries.*  For three-vessel coronary disease, a bypass is superior to stents, with the possible exception of cases where the blocked part of the artery is very short.

The same is true when more than three vessels are involved; hence, "quadruple" bypass (four vessels), "quintuple" bypass (five vessels), and beyond.

In some cases, a combination of stent placement and bypass (CABG) surgery is done, which may be performed together - called hybrid coronary revascularization - or as separate procedures.

*The three main coronary arteries are taken to mean the left anterior descending (LAD) and the circumflex (Cx, also on the left) arteries - both of which branch from the left main coronary artery (LMCA) - and right coronary artery (RCA).

Coronary Arteries

When stents are best

Bypass (CABG) is best for the most important artery - LAD

The three main coronary arteries are not all equal. The most important of them is the left anterior descending (LAD) artery. It supplies blood to the entire front wall of the heart, which represents much more muscle than the area fed by either of the other two arteries. It also represents the left ventricle - the heart's main pump that supplies blood to the brain and body. A narrowing or blockage in the LAD is, therefore, the most serious.

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RESOURCES

American Heart Association (AHA) - Heart Surgery & Recovery Resources

Harvard Health - Bypass or Angioplasty with Stenting?

Stanford Medicine

No content in this app, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

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