Minimally invasive procedures are defined as medical procedures that use small incisions and cause minimal damage to body tissue by both the American Institute for Minimally Invasive Surgery and Random House Dictionary.
Percutaneous coronary intervention—or PCI—is a nonsurgical procedure performed in the catheterization lab (cath lab) by an interventional cardiologist. Protected PCI™ is a PCI procedure performed with hemodyanmic support from the Impella 2.5™ heart pump. These procedures are considered minimally invasive because the interventional cardiologist makes a small incision and threads a catheter fitted with a device through an artery in the leg or arm to the heart. Once in place, the device is used to open up the blockage(s) in the heart, and after the procedure, the device is removed and the incision is stitched.
While the PCI procedure is appropriate for some patients with heart disease, a surgical procedure called coronary artery bypass grafting (CABG) may be recommended for others, depending on the patient’s medical condition. The CABG procedure reroutes blood around the blocked coronary artery. During the CABG procedure, the surgeon takes a blood vessel from the leg or arm and attaches this open blood vessel to the coronary artery before and after the blockage. Blood is then routed through the new blood vessel and around the blockage, bypassing it. Upon completion of the surgical procedure, all incisions are closed with stitches.
The goals of both the CABG and PCI procedures are the same—to restore blood flow to the heart and improve the quality of life for patients with coronary artery disease. CABG is an open heart procedure that requires the heart to be exposed for surgical repair. After surgery, the patient is monitored and may remain in the hospital for 5 to 10 days. Patients typically resume their normal activities 6 to 8 weeks after surgery.
Minimally invasive procedures such as PCI and Protected PCI often use a smaller incision that may require fewer stitches. The length of stay in the hospital can be 2 to 3 days and many patients resume their regular routine in about 2 weeks.
Patients deserve as many treatment options as possible when dealing with coronary artery disease. Talk with your doctor to discuss what procedure is best for your medical condition. Both procedures can improve the quality of life of patients with coronary artery disease.
- Read more about minimally invasive procedures
- Read more about coronary artery bypass grafting
- Read more about identifying patients for CABG and PCI
- Read more about PCI and Protected PCI
- Learn more about complex heart disease and advanced heart failure
- Learn more about Protected PCI
The Impella 2.5 system is a temporary (<6 hours) ventricular support device indicated for use during high-risk percutaneous coronary interventions (PCI) performed in elective or urgent, hemodynamically stable patients with severe coronary artery disease and depressed left ventricular ejection fraction, when a heart team, including a cardiac surgeon, has determined high-risk PCI is the appropriate therapeutic option. Use of the Impella 2.5 in these patients may prevent hemodynamic instability which can result from repeat episodes of reversible myocardial ischemia that occur during planned temporary coronary occlusions and may reduce peri- and post-procedural adverse events.
Protected PCI and use of the Impella 2.5 is not right for every patient. Patients may not be able to be treated with Impella if they have certain pre-existing conditions, which a cardiologist can determine, such as: severe narrowing of the heart valve, severe peripheral artery disease, clots in blood vessels, or a replacement heart valve or certain heart valve deficiencies. Additionally, use of Impella has been associated with risks, including, but not limited to valvular and vascular injury, bleeding, and limb ischemia in certain patients. Learn more about the Impella devices’ approved indications for use, as well as important safety and risk information at www.protectedpci.com/indications-use-safety-information/.