Heart Procedures and Surgeries

If you've had a heart attack, you may have already had certain procedures to help you survive your heart attack and diagnose your condition. For example, many people who have had a heart attack undergo thrombolysis, a procedure that involves injecting a clot-dissolving agent to restore blood flow in a coronary artery. This procedure should be administered within 30 minutes of the patient’s arrival at the hospital for maximum results. If this treatment isn't done immediately after a heart attack, many people will need to undergo coronary angioplasty or coronary artery bypass graft surgery (CABG) later to improve blood supply to the heart muscle. 

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See diagnostic tests and procedures to understand the tests you may have to find out if you had a heart attack, how much damage was done and what degree of coronary artery disease (CAD) you have.

Heart Procedures and Surgeries

Coronary Angioplasty

Also known as Percutaneous Coronary Interventions [PCI], Balloon Angioplasty and Coronary Artery Balloon Dilation.

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What the procedure does

Special tubing with an attached deflated balloon is threaded up to the coronary arteries. The balloon is inflated to widen blocked areas where blood flow to the heart muscle has been reduced or cutoff. Often combined with implantation of a stent to help hold the artery open and decrease the chance of another blockage. Considered less invasive because the body is not cut open. The procedure lasts from 30 minutes to several hours. May require an overnight hospital stay.

Reason for the procedure

  • Greatly increases blood flow through the blocked artery.
  • Decreases chest pain (angina).
  • Increases ability for physical activity that has been limited by angina or ischemia.
  • Can also be used to open neck and brain arteries to help prevent .

Medications that may be prescribed post-procedure

Learn more about cardiac medications, including dual antiplatelet therapy, that you may need to take after your procedure to prevent complications and to put you on the path for the best recovery.

View an Answers by Heart sheet: What is Coronary Angioplasty? (PDF)

Laser Angioplasty

What the procedure does

Similar to angioplasty except the catheter has a laser tip that opens the blocked artery. Pulsating beams of light vaporize the plaque buildup.

Reason for the procedure

  • Increases blood flow through blocked arteries.

Heart Valve Surgery

(Also known as Heart Valve Repair or Replacement Surgery)

What the procedure does

Repairs or replaces an abnormal or diseased heart valve with a healthy one.

Reason for the procedure

  • Restores function of the heart valves.

View an Answers by Heart sheet: Why Do I Need Heart Valve Surgery? (PDF)

Atherectomy

What the procedure does

Similar to angioplasty except that the catheter has a rotating shaver on its tip to cut away plaque from the artery.

Reason for the procedure

  • Increases blood flow through the blocked artery by removing plaque buildup.
  • May also be used in carotid arteries (major arteries of the neck leading to the brain) to remove plaque and reduce risk for stroke.

Bypass Surgery

(Also known as Coronary Artery Bypass Graft Surgery or CABG (pronounced "cabbage") 

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What the procedure does

Treats blocked heart arteries by taking arteries or veins from other parts of your body — called grafts — and using them to reroute the blood around the clogged artery to supply blood flow to your heart muscle. A person may undergo one, two, three or more bypass grafts, depending on how many arteries are narrowed. Requires several days in the hospital. .

View an Answers by Heart sheet: What is Coronary Artery Bypass Surgery? (PDF)

Reason for the procedure

  • One of the most common and effective procedures to manage blockage of blood flow to the heart muscle.
  • Improves the supply of blood and oxygen to the heart.
  • Relieves chest pain (angina).
  • Reduces risk of heart attack.
  • Improves ability for physical activity that has been limited by angina or ischemia.

Medications that may be prescribed post-procedure

Learn more about cardiac medications, including dual antiplatelet therapy, that you may need to take after your procedure to prevent complications and to put you on the path for the best recovery.

Heart Transplant

What the procedure does

Removes a diseased heart and replaces it with a healthy human heart when a person's heart is irreversibly damaged. Uses hearts from organ donation.

Reason for the procedure

  • Recognized as a proven procedure to restore heart health in select patients.

Minimally Invasive Heart Surgery

(Also known as Limited Access Coronary Artery Surgery and includes Port-Access Coronary Artery Bypass (PACAB or PortCAB) and Minimally Invasive Coronary Artery Bypass Graft (MIDCAB or minimally invasive CABG)

What the procedure does

An alternative to standard bypass surgery (CABG). Small incisions ("ports") are made in the chest. Chest arteries or veins from your leg are attached to the heart to "bypass" the clogged coronary artery or arteries. The instruments are passed through the ports to perform the bypasses. The surgeon views these operations on video monitors rather than directly. In PACAB, the heart is stopped and blood is pumped through an oxygenator or "heart-lung" machine. MIDCAB is used to avoid the heart-lung machine. It's done while the heart is still beating. Requires several days in the hospital.

Reason for the procedure

  • Manages blockage of blood flow to the heart and improves the supply of blood and oxygen to the heart.
  • Relieves chest pain (angina).
  • Reduces risk of heart attack.
  • Improves ability for physical activity.

Radiofrequency Ablation

(Also known as Catheter Ablation)

What the procedure does

A catheter with an electrode at its tip is guided through the veins to the heart muscle with real-time, moving X-rays (fluoroscopy) displayed on a video screen. The catheter is placed at the exact site inside the heart where cells give off the electrical signals that cause the abnormal heart rhythm. Then a mild, painless radiofrequency energy (similar to microwave heat) is transmitted to the pathway. This destroys select heart muscle cells in a very small area (about 1/5 of an inch).

Reason for the procedure

  • Preferred treatment for many types of rapid heartbeats (arrhythmias) especially supraventricular tachyarrhythmias.

Learn more about ablation.

Stent Placement

What the procedure does

A stent is a wire mesh tube used to hold open an artery that is placed during angioplasty. The stent stays in the artery permanently.

Coronary narrowings can form again within stents and are referred to as “restenosis.”

Reason for the procedure

  • Holds the artery open.
  • Improves blood flow to the heart muscle.
  • Relieves chest pain (angina).

View an Answers by Heart sheet: What is a Stent? (PDF)

Medications that may be prescribed post-procedure

Learn more about cardiac medications, including dual antiplatelet therapy, that you may need to take after your procedure to prevent complications and to put you on the path for the best recovery.

Learn more about stents.

Transmyocardial Revascularization (TMR)

What the procedure does

An incision is made on the left breast to expose the heart. Then, a laser is used to create a series of holes from the outside of the heart into the heart's pumping chamber. In some people, TMR is combined with bypass surgery. In those cases an incision through the breastbone is used for the bypass. Usually requires a hospital stay.

Reason for the procedure

  • Used to relieve severe chest pain (angina) in very ill people who would not be completely revascularized by CABG or angioplasty alone and may be at increased risk of heart attack. 

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