CHARLESTON, W.Va. (WSAZ) -- While heart health care is critical to West Virginians, a battle over who can provide treatment is pitting some hospitals against each other.

Hospital officials said this threatens to compromise patient care.

Currently, only hospitals with on-site cardiac surgery can perform an angioplasty, a procedure that clears blood flow to the heart. Smaller hospitals want the surgery option.

Gov. Joe Manchin has to make a decision on the issue by Friday. Meanwhile, both sides have launched emotional ads in newspapers throughout the state.

Officials at smaller hospitals say the ability to perform an angioplasty would saves lives instantly. Authorities at larger hospitals maintain that if something happens on the operating table, there is time lost transferring a patient to a facility that could save his or her life.

If Manchin approves letting smaller hospitals have the surgery option, West Virginia will be the 41st state in the country to allow angioplasties where there is no cardiac back up. Last week, the American Heart Association sent a letter to Manchin, recommending that he not approve this plan.