We have written these sections with the patient in mind, as an introduction to interventional cardiology. We welcome comments and suggestions from our readers, and also request that you read our disclaimer.

Coronary Artery Disease The coronary arteries supply a constant flow of oxygen-rich blood to the heart, which pumps almost 2,000 gallons of blood throughout the body each day. If plaque builds up in these coronary arteries, blockages can develop, reducing blood flow to the heart and causing symptoms ranging from mild chest pain to a heart attack, which can be fatal. Current treatments for coronary artery disease (CAD) in order of increasing invasiveness are:

plaque build-up in left coronary artery

• life-style changes in smoking, diet and exercise habits;
• an ever-increasing array of medications to control the progression of disease;
• interventions to restore blood flow, such as
  • angioplasty (removal or compression of the plaque);
  • bypass grafting (detouring around the blockages).

Angioplasty and bypass are mechanical "fixes" to what is essentially a biological problem. While both procedures can remove the immediate concern of blocked arteries, their effect on the long-term progression of CAD depends upon a large number of variables. One advantage of angioplasty is that it is much less invasive and more repeatable should the disease progress and lead to more blockages. But both procedures have been helpful in relieving chest pain, increasing quality-of-life and reducing the possibility of more dangerous manifestations of the disease.

Andreas Gruentzig in cath lab

The procedures and devices in this section will describe what is known generically as "angioplasty", a procedure first performed over 20 years ago by Andreas Gruentzig, in his search for less invasive ways to treat coronary artery disease. What he envisioned as an alternative to open heart bypass surgery in perhaps 5% of cases, has increased today to over 50%. ( See a video clip about the first coronary angioplasty.) Next Section: "The Cath Lab"