2nd bypass problems

[June__0__0]

     12 years ago, my husband had to have tripple bypass surgery.  Everything went well, and he was able to return to work after 6 weeks.  The only thing that happened during the 1st surgery was the diaphram was damaged and his left lung didn't inflate all the way.
     On 16 September 1997 he had another heart attack and 2 days later he underwent his 2nd bypass operation.  The arteries from his 1st surgery were fine according to the results from the angiogram.  These were 3 different arteries.
     When he came to after the surgery, his face and neck was swelled, and his voice sounded like he had inhaled from a hellium baloon.  He had to sit in a chair over the air conditioner in order to breath.  An x-ray showed that there was a hole in the top of his right lung that was letting air go between the layers of skin.
     He was released from the hospital on the 6th day following his surgery.  Within a couple days after he came home, his incissions on his chest and legs started to look red and inflamed.  They started to get puss and felt feverish.  We made an appointment with the surgeon, who said that he may be allergic to the material used to stitch him up.  My husband complained of chest pains and was told he was acting like a baby.
     When my husband went to see the Cardioligist he again complained of chest pain and was told to go to the hospital to get a Thallium Stress Test.  The test had to be stoped because of chest pain and blood pressure got too high.  The results came back, and the Dr called to get us over to discuss the results.
     2 of the bypassed from the 2nd surgery did not take and he does not want to redo them.
     My question is:  What would cause the bypasses not to take, and what else can my husband do now?  He is on total dissability, and still having chest pain.  He had to have a Holitor monitor that said his heart is skipping beats, and the Dr saaid this is very dangerous.  We really like this Dr and trust him very much, but I just can not beleive there is nothing else we can do.
  Thanks
  June
    

[CCF Cardio MD - MTR]

_

Dear June, thank you for your question.  Your husband has a complicated situation for which I will not be able to make any specific recommendations in the Heart Forum, but I'll provide some information that may help you.  Bypass grafts can fail soon after surgery due to technical problems with the grafts' insertions into the native coronary arteries or thrombosis of the grafts.  The options to relieve your husband's current chest pain include increased doses of anti-anginal medications (nitroglycerin, beta blockers, etc.), angioplasty, or redo bypass surgery.   Increasing anti-anginal medications often helps to relieve angina.  Angioplasty of the native arteries may be an option depending on many technical features, but this depends on the severity of the blockages in his native arteries.  Redo bypass surgery would be risky, given that he has already had two open heart surgeries and that he had many problems with the recent surgery.  If none of these options work for your husband, then he could be considered for new therapies that are currrently being investigated like laser revascularization procedures and growth factors that stimulate the growth of new blood vessels to the ischemic areas of the heart muscle.  Drs. Stephen Ellis and Patrick Whitlow (can be reached at the number below) are leading the investigations of these therapies at Cleveland Clinic.  The premature beats noticed on the Holter Monitor may be dangerous, but can potentially be treated, so make sure you ask his cardiologist about this issue.  
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.  Good luck.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.