If a coronary angiogram (a scan that shows blood flow) revealed that the left anterior descending artery was 95% blocked, what procedure might a cardiologist recommend?
The correct answer and explanation is:
If a coronary angiogram reveals that the left anterior descending (LAD) artery is 95% blocked, the cardiologist might recommend a procedure such as angioplasty (often with stent placement) or coronary artery bypass grafting (CABG), depending on the patient’s condition and overall health.
Angioplasty with Stent Placement:
In angioplasty, a catheter with a balloon at the tip is inserted into the blocked artery. The balloon is inflated at the site of the blockage to open up the narrowed artery, restoring blood flow. A stent, which is a small mesh tube, is often placed in the artery to help keep it open after the balloon is deflated and removed. This procedure is often recommended if the blockage is relatively localized, the patient is stable, and there are no significant complications or comorbidities like diabetes, which may complicate healing.
Coronary Artery Bypass Grafting (CABG):
If the blockage is severe and affects a larger portion of the artery, or if there are multiple blockages in different coronary arteries, CABG might be recommended. In this procedure, a surgeon takes a healthy blood vessel from another part of the body (such as the leg or chest) and uses it to bypass the blocked artery, rerouting blood flow around the obstruction. CABG is typically recommended for patients with more complex coronary artery disease or those who do not respond well to angioplasty.
Factors Influencing Procedure Choice:
The cardiologist will take into account several factors before deciding on the procedure. These include the patient’s age, overall health, and the location and extent of the blockage. In some cases, a less invasive angioplasty may be preferred if the patient is in good health and the blockage is accessible. However, if the artery is severely narrowed or there are additional blockages elsewhere, CABG may provide a longer-term solution. The decision is also influenced by the presence of other health conditions like diabetes, kidney disease, or hypertension.