Are angioplasties or bypass surgeries more common in Singapore, and why?

Doctor's Answers 1

In general the number of heart bypass surgeries has been falling globally as heart angioplasty (heart stent) technology has improved in leaps and bounds especially over the last decade.

Surgical techniques have also improved and newer techniques such as off-pump bypass or MIDCAB are available.

However, the reason why angioplasties are more popular are because of the quick recovery and absence of the need for open surgery though there maybe a need for repeat procedures.

Patients however, have been voting with their feet for coronary angioplasty even when aware of both the upside and downside of either option and this is a universal phenomenon.

Bypass surgery has less upstream advantages, but in certain circumstances has a longer-term benefit such as in complex extensive disease in many vessels with poor heart function or diabetes.

This strategy however is not always a given and individual patients may need consideration by the heart team – comprising of both cardiologist, cardiac surgeon, family physician and any other related specialist involved in care, along with patient for deciding the optimal strategy.

Similar Questions

When is an angioplasty or angiogram performed in Singapore?

A coronary angiogram is performed whenever a patient has symptoms such as breathlessness or chest pain on exertion (not always) which usually indicate poor blood flow in the heart blood vessel due to blockages. This could a non-invasive angiogram (ie CT coronary angiogram) or an invasive coronary angiogram (gold standard test). The modality depends on the risk and if the risk is higher an Invasive coronary angiogram maybe warranted.

Photo of Dr Nandakumar Ramasami

Answered By

Dr Nandakumar Ramasami

Cardiologist

Why do doctors not perform angioplasties for minor blocked heart vessels?

All procedures are carried out after a clinical assessment of risk vs benefit. As mentioned above there is always a risk to any invasive procedure and angioplasties on minor vessels just do not justify a patient undergoing the risk of an coronary angioplasty as some of the risk, though of low frequency, if they do occur can be significantly life altering. And while treating a severe narrowing in an important vessel has a favourable prognostic benefit (ie prolongs life but this is a hidden benefit) the same does not pply to smaller vessels.

Photo of Dr Nandakumar Ramasami

Answered By

Dr Nandakumar Ramasami

Cardiologist

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