As his coronary angiogram has shown 3-vessel disease (disease present in three different coronary arteries) Hamish is referred to the cardiothoracic team for assessment for Coronary Artery Bypass Graft (CABG) Surgery.
The potential management outcomes as a result of performing a Coronary Angiogram include:
| Medical Management (pic of tablets) | All patients with ischaemic heart disease require medication to reduce the progression of the disease and reduce the risk of complications. This is sometimes called secondary prevention. Patients who have medical management for their angina are also prescribed anti-anginal medication to reduce their chest pain. Anti-anginal medications can work by reducing the work the heart has to do or by dilating the coronary arteries to improve coronary blood flow. Medical therapy can be very successful for patients with mild to moderate coronary disease or is sometimes appropriate in patients who have contra-indications to either angioplasty or bypass surgery. For some patients anti-anginal medication is not completely successful at relieving their symptoms and for these patients further consideration of revascularisation is appropriate. |
Coronary Artery Bypass surgery (CABG) |
This is a surgical procedure with a significant recovery period. It is often appropriate when there is extensive disease of the coronary arteries or when PCI is technically difficult. It is often the treatment of choice for patients with Diabetes Mellitus. The surgeon can use a variety of different vessels to act as bypass grafts including the internal mammary artery (from the chest), saphenous vein (from the leg) or radial artery (from the arm).
To view an animation of a coronary bypass see the following NHS Choices:Coronary Artery Bypass Graft |
| Percutaneous Coronary Intervention (Stents, pic of stents) | PCI involves stretching an area of narrowed artery with a balloon and then implanting a metal stent which acts as a scaffold to prevent re narrowing of the artery. This is often used where there is only a small segment of disease in a single artery. It is possible to treat multiple areas in multiple arteries with stents but evidence shows that for patients with extensive disease coronary artery bypass surgery can provide better long term relief of symptoms. |
Page last reviewed: 09 Jun 2020
