HEART DISEASE EXPERT FORUM
100% blocked coronary artery

100% blocked coronary artery

My husband is recently diagnosed with his right coronary artery 100% blocked, and his left main with three consecutive blockages of 80%, 70%, and 70%. The doctor did one angioplasy on him and put two overlapping stents on the left main. He is saying that the left main is going to be okay now. But as my husband is only 48years old he is suggesting to try a second angioplasty on the RCA to open it up although he is not fully sure whether he will be able to open it or not. He also mentioned that there is a risk of a heart attack and an artery rupture during this procedure since this is a 100% blockage. I have no idea what to do, and I am living every moment with fear now. I myself have developed hypertension while dealing with it. My husband also has diabetes for last 12 years.Please help me, and tell me whether I should let my husband to go for the attempt of angioplasty or not.
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I think that what happened to your husband, if actually as described is very close to medical malpractice. He would have benefited from open heart surgery, with bypass grafts to the LAD, LCX and RCA. This is especially true given the fact that he is 48 years old, and that graft to the LAD would have stayed open on average of 20 years. Now the stents placed in the LAD may stay open that long but this is not very likely.  If your local surgeon turned him down for surgery, then you should seek the advise from a more experienced surgeon, such as one at any tertiary care referral center. To perform an unprotected left main stenting, with and RCA that is 100% occluded should not be attempted , in my opinion, unless there is a contraindication to open heart surgery. Depending on the type of stents placed in his heart you may need to wait up to one year before open heart surgery can be considered. If this is the case then I would seek the most experienced interventioanl cardiologist to open the RCA, provided it is  in fact necessary. This is not an easy decision to make and you need an expert opinion. Once again this decision is individualized to each patient and is best made at a large tertiary care facility such as ours.  
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