The first thing to understand about the anatomy is that the heart is constantly beating, so the heart also needs blood vessels to power him. The blood vessels that supply the heart are called coronary arteries. The average person has two coronary arteries, the left coronary artery and the right coronary artery.

The full name of coronary heart disease is coronary atherosclerotic heart disease, which refers to the occlusion of coronary arteries from various causes, causing insufficient blood supply to the heart.

Cardiac bypass is actually a vascular grafting surgery, which takes a section of your own blood vessel, connects one end of this blood vessel to the aorta and one end to the heart, which is equivalent to recreating a coronary artery, and it is suitable for patients with severe coronary artery occlusion.

A cardiac stent, on the other hand, is an intervention in which one or more stents are placed into the coronary arteries to hold the narrowed artery open and restore blood flow to the heart. It is used for patients whose stenosis is not as severe.

To give you a simple example, let's say you are driving to a place and the road in front of you is blocked by an obstacle. Coronary bypass is equivalent to rebuilding a road to bypass the obstacle. A cardiac stent is the equivalent of using a tool to chisel away the obstacle so that the car can pass through, so you should understand the explanation.

Coronary stents and coronary bypass grafts are both a means of treating coronary heart disease and have many things in common as well as many differences.

First of all, coronary stenting is a minimally invasive procedure, local anesthesia, from the wrist (radial artery) or thigh (femoral artery) through the skin puncture, delivering a guide wire, catheter, injecting a contrast agent, and observing the coronary arteries through the X-ray display, which are narrowed and blocked, and then delivering a stent, releasing it in the narrowed area, propping up the vessel, and making the flow of blood open, an endoluminal solution, done by cardiologists. This solution solves most coronary stenosis problems. A small number of complex and specialized areas where coronary stents are not appropriate can only be solved by bypass surgery.

Bypass surgery requires an open chest, general anesthesia, and depending on the strength of the hospital, its habits, and the type of lesion of the patient, there are conventional median chest incision and small lateral chest incision, etc. Bypass surgery selects its own blood vessels to drain from the normal side to the distal end of the stenosis, which is similar to the saying "if this way is not possible, then bypass it", and the selected blood vessels are commonly used, such as the veins of lower limbs, internal thoracic arteries, which is done by the cardiac surgery. Commonly used vessels are lower extremity veins and internal thoracic arteries, which are performed by cardiac surgery.

Neither stenting nor bypass surgery is a one-time solution, and long-term standardized medication is needed after surgery to ensure that stenting and bridging vessels usually, prolong life and reduce complications.

Thanks! Cardiac bypass and stenting are both surgical procedures to treat coronary artery disease and improve blood supply to the heart muscle.

Cardiac bypass is a cardiothoracic surgical procedure for severe and complex coronary artery lesions. Examples include left main stem lesions, multi-branch diffuse lesions, severely calcified lesions, and bifurcation lesions. The surgery usually requires an open chest and begins with the removal of a bridging vessel, usually the internal thoracic artery, internal mammary artery, saphenous vein, and radial artery as the bridging vessel. This is done by placing one end of the bridging vessel on the ascending aorta and the other end on the distal vessel of the stenotic coronary artery lesion, so that blood flow from the ascending aorta bypasses the stenotic or completely occluded lesion and reaches the distal end directly. This improves blood supply to the heart muscle.

In recent years, cardiac bypass grafting has also evolved in a minimally invasive direction. For example, if the anterior descending branch is chronically and completely occluded and cannot be opened by stenting, the left internal mammary artery is pulled down and hitched to the distal end of the diseased vessel under direct thoracoscopic visualization.

Cardiac stents are used to improve blood supply to the heart muscle by expanding the stent to open up a stenotic or completely occluded lesion, allowing blood to flow smoothly through the originally narrowed lesion to the distal end. Cardiac stents are generally used for relatively simple coronary artery lesions. Of course, with the exploration and development of technology, stenting can also be used to resolve many complex lesions that would otherwise require bypass grafting, resulting in less trauma for the patient, quicker post-procedure recovery, and shorter hospital stays. With stent banding also saves patients' medical costs.

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Coronary heart disease has become a very common type of disease in the country.

Currently.Oral drug therapy, coronary artery bypass surgery, and coronary stenting have become the triad of treatment for coronary artery disease, and Little Eye is here today to explain the differences.

Coronary stenting is much less damaging than bypass surgery.

Many people worry about surgical bypass surgery as long as the reason comes from the fear of open chest, small eyes doctor has seen bypass surgery after the patient's wound, almost 20cm scar, this is almost a chest as long as the...That's why it's so hard for most patients to accept.

The wound after coronary stenting is much smaller, almost just the size of a puncture needle, and heals very quickly.

But for critically ill patientsBypass surgery is also recommended first.

For three-branch arterial lesions, theThat is, when the anterior descending artery, the circumflex artery, and the right coronary vessel all have stenosis, or when there is stenosis in the left main vessel, stenting is more risky.

And, especially for three-branch lesions, the number of stents placed is relatively high, and in many cases even able to put in seven to eight stents, and given the risk issues, the economic issues, the first recommended coronary artery bypass grafting surgery.

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This is a very good question! Up to now, cardiac bypass and cardiac stent are the 2 most effective surgical methods for treating coronary artery disease besides medication, both of which are extremely important for improving the blood supply to the patient's myocardium, relieving angina symptoms, improving myocardial function, improving the patient's quality of life, and prolonging the patient's lifespan.

The world's first heart bypass surgery was done in 1967; the world's first cardiac stent intervention was done in 1986, a difference of nearly 20 years.

So what's the difference between a heart bypass and a heart stent? Today I'm going to join the gang and talk about that, just for reference.

Difference in meaning between cardiac bypass and cardiac stent

1. Heart bypass, also known as coronary artery bypass grafting, which involves taking a blood vessel from your own body between the proximal and distal ends of a narrowed coronary artery and building a channel to allow blood to bypass the narrowed coronary artery and reach the ischemic area

2. cardiac stents.Also known as a coronary stent, it is a medical device that is used clinically through an interventional procedure to deliver a stent to a lesion to hold up a narrowed coronary artery, allowing blood to flow through the arterial vessels.

Difference between cardiac bypass and cardiac stent materials

1. Materials used for heart bypassThe patient's own blood vessels are usually saphenous vein tubes, internal mammary artery tubes, radial artery tubes, and so on.

2. Materials used for cardiac stents, which can be a metallic material, a drug-coated material, a bioabsorbable material; and the shape of the scaffold can be mesh, tubular, wrap-around, annular, and so on.

Difference between cardiac bypass and cardiac stent indications

Heart Bypass vs. Heart StentCommon indications, all of which are designed to address the problem of blood supply to healthy blood vessels due to narrowing of the heart's coronary arteries.

Heart Bypass vs. Heart StentThe different indications are thatThose that can be solved with a heart stent don't need a heart bypass because a heart bypass is, after all, a major open-heart surgery, whereas a heart stent is a minor interventional procedure.

So, to use a not-so-subtle analogy, a heart bypass and a heart stent are just likeinjectable antibiotics versus oral antibiotics.Injectable antibiotics are not used if they can be treated with oral antibiotics.

Cardiac bypass, specifically, is indicated for at least the following six situations that cannot be addressed by cardiac stents.

1. The patient had severe diffuse stenosis of the coronary arteries, which prevented the placement of a cardiac stent and necessitated major open-heart surgery.

2. Failure of cardiac stent intervention, or occurrence of acute complications, such as acute myocardial infarction with cardiogenic shock.

3. The patient is allergic to antiplatelet drugs because after the cardiac stent is installed, the patient needs to take antiplatelet drugs.

4. Left main coronary artery lesions, preferred heart bypass surgery, because the left main trunk is like the roots of a tree, once the left main trunk lesions, may lead to the entire left coronary artery blood supply is insufficient.

5. Three or more vessels of the coronary arteries, which have developed diffuse lesions, are preferred for cardiac bypass grafting.

6. Patients with cardiac insufficiency requiring complete revascularization to facilitate recovery of the ischemic myocardium, starting with cardiac bypass surgery

Other indications situations need to be performed as prescribed by the physician.

To summarize:The common indications for cardiac bypass and cardiac stents are to address the narrowing of the coronary arteries of the heart, which leads to problems with the supply of blood to healthy vessels.

A different indication for cardiac bypass versus cardiac stents is that cardiac bypass is not needed for those that can be addressed with cardiac stents, because cardiac bypass is, after all, a major open-heart surgery, whereas cardiac stents are minor interventional procedures.

One of these, cardiac bypass, applies to at least six situations that cannot be resolved with a cardiac stent.

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Coronary artery bypass surgery and coronary stenting are two effective ways to treat coronary artery disease. What are the differences between the two?

I. The departments in which the two surgeries are carried out are not the same

1. Coronary stenting

It belongs to the internal medicine surgery, and should be admitted to the cardiology department for treatment. Stent surgery is generally less damaging to the patient, as long as local anesthesia can be used during the operation, and the recovery after the operation is relatively fast, you can walk on the ground on the same day after the operation.

2. Coronary bypass surgery

It is a surgery carried out by the Department of Thoracic and Cardiac Surgery. The damage to the patient is more ballistic, need to open the chest to do, and to general anesthesia. Postoperative recovery is also relatively slow.

II. The scope of application of the two is not the same

Because stenting is less damaging to the patient and the recovery is quicker, stenting is usually the first thing that is done for patients with coronary artery disease for whom medication is ineffective. Moreover, with the continuous progress of stenting, many problems that could not be solved by stenting in the past may be slowly overcome.

Coronary bypass surgery, on the other hand, is more like a treatment of last resort for coronary artery disease, when stenting fails and there is no other way to go for coronary bypass surgery.

Third, the mechanism of the two roles is not the same

1. Coronary stenting

As shown in the figure, coronary stenting is a procedure in which a blockage in a coronary artery is first widened with a balloon, and then a stent is placed into it to hold the blocked plaque open and restore blood flow supply.

2. Coronary bypass surgery

As you can see in the picture above, the red circle has a plaque that is blocking the blood vessel, resulting in a lack of blood supply to the distal vessel. Coronary artery bypass grafting involves taking a section of a blood vessel from another part of the body (internal mammary artery, saphenous vein, etc.), connecting one end to the aorta, and the other end to the distal end of the plaque, which directly spans the blockage, as if a new bridge had been built.

There are no obvious advantages or disadvantages to either, just that each applies to a different range of applications.

Dr. Yang Zhaohua, Deputy Chief Physician of Cardiac Surgery Department, Zhongshan Hospital, Fudan University, introduced:

Both cardiac bypass and stents are used as conventional treatments for coronary heart disease, each with its own advantages and disadvantages. Cardiac stent is also known as coronary artery, but not every coronary artery disease patient is suitable for the use of cardiac stent, in general, acute myocardial infarction, unstable angina, etc. can be treated with stent. Comparatively speaking, cardiac stenting is less traumatic to patients, and the postoperative recovery of patients is faster, but it has its adaptive range. Generally speaking, if one or two blood vessels have problems, some patients will choose to go to stenting, but the long-term effect may still be a little bit worse than that of cardiac bypass surgery. It should be said that nowadays the scope of cardiac bypass surgery is wider, and the long-term effect is statistically more accurate and better than stent. However, it also has its shortcomings. Many patients may feel that the operation will affect their recovery and may have some concerns about the risks of the operation. Specific treatment measures need to be chosen according to the actual situation of the patient.

The difference between a bypass and a stent lies in the principle of solving the problem. Simply put, when an important blood vessel becomes narrowed and blocked, the doctor needs to find a way to make the vessel open, and bypasses and stents are two common ways to do this. A bypass is a procedure that uses another blood vessel to directly cross the narrowed ends of the blood vessel so that blood can go directly through the new blood vessel. It is similar to building a bridge over a broken or collapsed road to ensure that the road is open. Stenting is not to take a new blood vessel, directly in the stenosis of the narrow blood vessel to put a stent, the blood vessel up, to ensure the smooth flow of blood.

It is just that each of these two procedures has its own indications, and it is not the case that a stent is necessarily better than a bypass or that a bypass is necessarily better than a stent. In principle, both procedures may be used in important vessels throughout the body, but they are more often used in heart-related diseases.

Indications for cardiac bypass surgery

The main indications for heart bypass surgery, which are also known as which symptoms are suitable for heart bypass surgery, are:

1. Left main stem lesion;

2. Diffuse lesions with severe stenosis in three or more vessels.

3. Accompanied by heart failure, requiring complete revascularization to restore the myocardium.

4. There are more comorbidities, such as more severe vasculopathy due to diabetes.

5. Severe coronary artery injury, cardiac tamponade, septal perforation and other cardiac emergencies

6. Cardiac bypass may also be considered in patients who cannot tolerate anticoagulants after cardiac stent placement.
   

Indications for cardiac stenting

1. Acute myocardial infarction;

2. Poor medical outcomes of angina medications, including stable and unstable angina;

3. Coronary angiography suggests more than 75% stenosis of the vessel.

How exactly do you choose?

The choice of surgery needs to be determined on a case-by-case basis, minimally invasive is the direction of development, cardiac stenting is less invasive, with the development of technology, stenting may become more and more widespread indications, of course, everything depends on the specific circumstances, not for the sake of minimally invasive and minimally invasive, all the patient's health interests as the benchmark.

What is the difference between a heart bypass and a stent?

In general, stenting is a minimally invasive procedure with very minimal trauma and recovery is relatively quick. The recovery of physical strength, the recovery of the clinical situation is faster. It is done by means of an intervention in our peripheral vessels, let's say our radial and femoral arteries, and then the stent is delivered through a catheter to the stenosis in our coronary artery, and then the stent is propped open.

Coronary artery bypass grafting, on the other hand, usually requires an open chest.Of course, there are some coronary artery bypass grafts that can be performed minimally invasively, and this is limited to our anterior descending vessels.

Then for stents and bypasses, there are pros and cons to each.Of course, for the same lesion, if stenting is indicated, we may not take such a means as bypass. If there are specific lesions, such as severe left main lesions, or multibranch lesions combined with diabetes mellitus, we have to score them according to the clinical situation and the specifics of the lesion, and in some cases the benefit of bypass is greater.

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Many friends often confuse cardiac bypass and cardiac stent, in fact, these two procedures, are commonly used to treat cardiovascular stenosis, but the difference is still quite big.

Heart bypass belongs to cardiac surgery;

Cardiac stents belong to the department of cardiology;

Heart bypasses require incisions, most of which require an open chest, and are considered major surgery;

Heart stents are non-invasive, a minimally invasive procedure that only requires a needle to puncture a blood vessel;

Heart bypass requires anesthesia and during the procedure, the patient is anesthetized;

Cardiac stents do not require anesthesia, only a small local anesthetic, and the patient is fully awake throughout the procedure;

With heart bypass, a blood vessel is taken from another part of the body and stitched to the heart;

Cardiac stenting, which is the process of opening up a previously severe blood vessel, supports the narrowed vessel with a stent and restores the normal official lumen of the narrowed vessel and normal blood flow;

With heart bypass, recovery from surgery is relatively slow because most of the chest is opened, and after the chest is opened, it needs to be closed with staples, so recovery from surgery is slow, and you have to stay in a care unit after surgery;

With cardiac stents, the recovery from the procedure is quick and relatively painless for the patient; angina patients can walk in and out of the operating room and be discharged from the hospital very quickly;

When an acute myocardial infarction occurs, the most commonly used to save the emergency is stenting, acute myocardial infarction patients temporarily have no way to carry out bypass, so life-saving only stenting.

Both cardiac stent and cardiac bypass are suitable for severe myocardial ischemia, severe cardiovascular stenosis that cannot be controlled by drugs. Whether to choose stents or bypass depends on the results of the imaging. Generally speaking, for relatively simple lesions, or fewer lesions, stents are chosen; however, for very complex vessels, or if many stents are needed, then bypass is recommended. The exact choice needs to be determined by each individual's angiogram.

In short, it can't be said that stents are better or bypasses are better, it depends on the blood vessels, but no matter stents or bypasses, you need to live a healthy life for a long time after the operation, take your medication on time for a long time, and have regular checkups.

[Copyright Dr. Cardiovascular Wang]