Expert heart disease care in Salt Lake City, Utah

At St. Mark’s Hospital in Salt Lake City, Utah, our coronary specialists’ number one priority is treating your coronary artery disease to restore the health of your arteries and heart.

For more information about coronary artery disease treatments at St. Mark’s, please call (855) 413-7829.

We treat coronary artery disease with a number of procedures, such as renal angioplasty, coronary angioplasty, coronary artery bypass and more. Regardless of the type of coronary artery procedure you need, you are in expert hands at St. Mark’s Hospital.

Coronary artery conditions

Coronary artery disease (CAD) is a type of heart disease in which plaque builds up in your coronary arteries. To understand CAD, you must first understand how your heart works.

Your heart is a muscle that pumps blood throughout your body. To work correctly, your heart needs a steady supply of oxygen. It gets this oxygen from blood supplied by the coronary arteries.

There are four main coronary artery conditions:

  • Healthy artery: When a coronary artery is healthy and has no blockages, blood flows through easily. Healthy arteries can easily supply the oxygen-rich blood your heart needs.
  • Damaged artery: Coronary artery disease begins when damage leads to the development of fatty streaks that progress into plaque (a fatty substance) building up within the artery wall. This damage could be caused by things like high blood pressure or smoking. This plaque buildup, called atherosclerosis, begins to narrow the arteries carrying blood to the heart.
  • Narrowed artery: As more plaque builds up, your artery has trouble supplying blood to your heart when it needs it most, such as during exercise. You may not feel any symptoms when this happens. Or, you may feel angina pressure—tightness, achiness or pain in your chest, jaw, neck, back or arm.
  • Blocked artery: Plaque may tear, completely blocking the artery, or a blood clot may plug the narrowed opening. When this happens, blood flow stops. Without oxygen-rich blood, part of the heart muscle becomes damaged and stops working. You may feel crushing pressure or pain in or around your chest. This is a heart attack (acute myocardial infarction, or AMI).

Coronary artery disease procedures in Salt Lake City, Utah

St. Mark’s Hospital has extensive experience treating coronary artery disease. With advanced testing and surgical technology, we ensure the Greater Salt Lake City area receives the best heart disease care and treatment.

The main goal of all coronary artery procedures is to improve blood flow. Your doctor will talk to you about your heart problem and which treatment will be most effective.

Always talk to your doctor about possible complications and risks of coronary artery procedures, any allergies, whether you’re pregnant or planning to be, breastfeeding and any pre-operative instructions.

Coronary artery disease procedures include:

Coronary angioplasty

In a coronary angioplasty, a medical balloon is inserted into the coronary artery, which pushes the plaque against the artery wall and improves blood flow to your heart.

illustrates how the balloon compresses the plaque against the artery wall

The balloon compresses the plaque against the artery wall.

Blood flow to the heart muscle increases.

How a coronary angioplasty works

  • The skin at the insertion site (usually the groin) is numbed with a local anesthetic. A needle puncture is made so the catheter can be inserted.
  • A guide wire is inserted through the guiding catheter (a thin, flexible tube) and moved to the narrow spot in your artery. Your doctor tracks its movement on an angiogram, a special kind of X-ray.
  • A balloon-tipped catheter is inserted through the guiding catheter and threaded over the guide wire. It is positioned at the narrow part of the artery.
  • The balloon is inflated and deflated several times to compress the plaque against the artery wall. You may feel angina (chest pain) when the balloon is inflated. Tell your doctor if you do.
  • The balloon is deflated and the catheters and guide wire are removed. The artery is now open, and blood flow to the heart muscle increases.

After the procedure

Your doctor or nurse will tell you how long to lie down and keep the insertion site still. A nurse will check the insertion site and your blood pressure. Before going home, you may have a chest X-ray and other tests. You usually remain in the hospital for several hours or overnight.

Contact your healthcare provider if:

  • You have angina (chest pain).
  • The insertion site has pain, swelling, redness, bleeding or drainage.
  • You have severe pain, coldness or a bluish color in the leg or arm that held the catheter.
  • You experience blood in your urine, black or tarry stools or any other kind of bleeding.
  • You have a fever over 101°F (38.3°C).

Peripheral angioplasty

In a peripheral angioplasty, a medical balloon is inserted into the peripheral artery to improve blood flow to your lower body, legs and arms.

How a peripheral angioplasty works

  • You may get medicine through an IV (intravenous) line to relax you. An injection will numb the site. Then the doctor makes a tiny incision near an artery in your groin.
  • Your doctor puts a thin catheter through the incision and then threads the catheter into an artery while looking at a video monitor.
  • Contrast “dye” is injected into the catheter. X-rays (angiography) are taken.
  • A tiny balloon is pushed through the catheter to the blockage. Your doctor inflates and deflates the balloon a few times. This compresses the plaque. A small metal or mesh tube (stent) may be put in the artery to help keep it open. The balloon and catheter are then taken out.

After the procedure

You’ll be taken to a recovery area. Pressure is put on the insertion site for about 15 minutes. Your doctor or nurse will tell you how long to lie down and keep the insertion site still. You will go home that day or spend the night in the facility, and you will be given care instructions for when you go home.

Call your healthcare provider right away if:

  • You notice a lump or bleeding at the site where the catheter was inserted.
  • You feel pain at the insertion site.
  • You become lightheaded or dizzy.
  • You have leg pain or numbness.

Renal angioplasty

In a renal angioplasty, a medical balloon is inserted into the renal artery to improve blood flow to your kidneys. A metal mesh tube, called a stent, may be inserted into the artery to help keep it open. 

How a renal angioplasty works

  • You may get medicine through an IV (intravenous) line to relax you. An injection will numb the site. Then the doctor makes a tiny incision near an artery in your groin.
  • A thin catheter will be inserted through the incision and then threads the catheter into an artery.
  • Contrast “dye” is injected into the catheter. X-rays (angiography) are taken and used as a guide to travel through your artery to your kidney.
  • A tiny balloon is pushed through the catheter to the blockage. Your doctor inflates and deflates the balloon a few times. This compresses the plaque. A small metal or mesh tube (stent) may be put in the artery to help keep it open. The balloon and catheter are then taken out.

After your procedure

You’ll be taken to a recovery area. Pressure is put on the insertion site for about 15 minutes. Your doctor or nurse will tell you how long to lie down and keep the insertion site still. You will go home that day or spend the night in the facility. Drink plenty of fluids to help you flush the X-ray dye out of your body. You will be given care instructions for when you go home.

Possible risks and complications include:

  • Bruising at the insertion site.
  • Bleeding inside your body or around the insertion site.
  • Damage to the artery, such as the blockage getting worse and possible kidney damage.
  • Problems due to the X-ray dye, such as an allergic reaction or kidney damage.

Coronary atherectomy

In a coronary atherectomy, a special device is used to grind the plaque away within the artery, improving blood flow to your heart.

illustrates location of possible insertion site in middle of right arm as well as upper right thigh groin area

How a coronary atherectomy works

  • The skin at the insertion site (usually the groin or arm) is numbed with a local anesthetic. A needle puncture is made so the catheter can be inserted. 
  • A guide wire is inserted through the guiding catheter (a thin, flexible tube) and moved to the narrow spot in your artery. Your doctor tracks its movement on an angiogram, a special kind of X-ray.
  • Then, a special atherectomy catheter carrying a grinding device is positioned at the narrow spot in your coronary artery.
  • An abrasive burr near the tip of the catheter grinds the plaque into small particles that float harmlessly away in the bloodstream.

After the procedure

Your doctor or nurse will tell you how long to lie down and keep the insertion site still. If the insertion site was in your groin, you may need to lie down with your leg still for several hours. A nurse will check the insertion site and your blood pressure. Before going home, you may have a chest X-ray and other tests. You usually remain in the hospital for several hours or overnight.

Contact your healthcare provider if you:

  • You have angina (chest pain).
  • The insertion site has pain, swelling, redness, bleeding or drainage.
  • You have severe pain, coldness or a bluish color in the leg or arm that held the catheter.
  • You experience blood in your urine, black or tarry stools or any other kind of bleeding.
  • You have a fever over 101°F (38.3°C).

Coronary artery bypass

If one or more of your coronary arteries are blocked, blood can’t flow to the heart muscle. In this case, the heart muscle may die (heart attack) or become weakened, damaged and cause chest pain (angina).

Problems like shortness of breath, increasing fatigue or leg swelling may occur. Coronary artery bypass surgery creates a path for blood to flow around a blockage to reduce the risk of further heart damage and symptoms.

Illustrates the location of the internal thoracic mammary arteries in the chest wall

How a coronary artery bypass works

  • First, a healthy blood vessel (graft) is taken from another part of the body. If you have more than one blockage, more than one graft may be needed. Sometimes your team will do ultrasound tests to look at the possible grafts prior to surgery.
  • While one member of the bypass team is harvesting the graft(s), another member works to expose your heart making an incision on your chest and opening the sternum.
  • A small opening is made in the coronary artery, past the blockage, and the graft is sewn in. The diseased artery and any stents are not removed. Blood flow is improved.
  • Your breastbone will then be rejoined with wires. These wires will stay in your chest permanently. Rarely do they cause a problem, and they are safe around microwaves and airport metal detectors. The incision is closed, and you are taken to the intensive care unit (ICU) to begin your recovery.

Using a heart-lung machine

Coronary artery bypass surgery can be done with the heart still beating (off pump) or with the heart still (on pump.) Your surgery team can tell you more about which type of procedure you will have:

  • On-pump procedure means a machine does the work of your heart and lungs during surgery. Blood is circulated through a heart-lung machine. The machine supplies the blood with oxygen and pumps it back through the body. In these cases, the heart may be stopped temporarily before the graft is attached. Your own heart and lungs start working again after the bypass is completed.
  • Off-pump procedure means the heart-lung machine is not used and the heart is not stopped. This is sometimes called a "beating heart" procedure.

There are advantages and disadvantages to each technique. If you have a question about why your doctor is using one technique, instead of the other, do not be afraid to ask.

Risks and complications

You and your surgeon can discuss the risks and possible complications of coronary artery bypass surgery. They may include:

  • Excessive bleeding, sometimes requiring a transfusion or a trip back to the operating room
  • Infection of the incision sites
  • Pneumonia (lung infection)
  • Fast or irregular heartbeat, which is almost always temporary
  • Nerve injury or muscle spasms
  • Breathing problems
  • Memory problems or confusion
  • Heart attack, stroke or death
  • Damage to other parts or organs of your body due to problems with blood circulation

Contact us

For more information about our coronary artery disease treatments, or to schedule an appointment with our coronary specialists, please call (855) 413-7829.