My father bypass surgery (CABG). has been done in 2005 after he is having chest pain so that we did angiography test after test doctor said his svg to pda is 100% blocked and rest three LIMA to LAD SVG to OM and SVG to Diagonal is normal. due to 100% blockage doctor refused the angioplasty operation for SVG to PDA and still he is having pain after taken so much medicine. now he is using sorbitrate during high pain after taken the sorbitrate he felt relaxed. please suggest me what to do for this problem. please do the needful
Hi, understand your anxiety. But based on the findings in stress testing, your doctor may decide on techniques to open up the block in the single vessel like stenting. The myocardium supplied by the vessel has to be viable, only then it can be saved if blood supply is restored. In stress testing, perfusion defect that persists after exercise and at rest is referred to as a fixed defect. There is an area (or areas) of the heart muscle that has become scar tissue (scarring, scarred) because of the MI. This area would not be able to make functional use of any oxygen even if blood flow to that area of the heart were completely restored. So, please discuss the options with your consulting doctor. Regards.
I think we are jumping ahead of ourselves here.
First of all, your Father had bypass surgery back in 2005 after his arteries were looked at by a group of experts. They obviously decided which areas of the heart muscle required a better blood flow and the PDA was obviously taken into account. HOWEVER, we have no idea what the condition of the PDA was? It may have been 70-99% blocked (unlikely 100%). So they grafted a Vein to this vessel which was removed from his leg. Now, that Vein has fully blocked, so his situation in the PDA is now close to what it was in 2005, which is not mentioned. If the PDA is just 70-90% blocked, then they may have felt it more risky to try and stent the Vein than leave it alone. Trying to get a catheter through a long calcified 100% blockage IS risky and internal bleeding is likely to result. This is probably why they refused. So, what we need to know is the missing piece of the puzzle, the actual condition of the native PDA. If this has a blockage of 70-99%, AND it is considered the cause for his discomfort, then I'm sure there's a cardiologist who can stent this and get his normal native PDA artery back open.If the PDA is 100% blocked, then a nuclear perfusion scan would be valuable to determine how much muscle damage there is, if any.
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