Block in graft with in 6 months of surgery

[prasanth1989]

hello sir, my father aged 49, is a diabetic. underwent CABG with 3 grafts on 03.06.2010. He developed effort angina II since 3 months. He underwent TMT which was inconclusive. He underwent coronary angiogram on 30.11.2010. It showed triple vessel disease, patent LIMA to LAD with occluded venous grafts. The case was discussed and was decided to address the significant OM1 lesion by doing PCI to OM1. can i go for PCI now ? is it right solution ? pl suggest me dr..

[ed34]

What is very often overlooked is the psychological aspects, all emphasis seems to be on the physical. Your Father is young and I was 2 years younger than him when I had my first stent. This was followed by a triple bypass which lasted 3 months. I was put on lots of medication which to be honest made me so lethargic, I felt imprisoned. When you are that age, you want energy and the ability to do things, it's far too soon to accept a lower pace of life. These are important things to consider. After my bypass failed, I had only two options. One was to keep on medication until my heart deteriorated enough to have a transplant, or the other was to have the blockage removed and have stents. I chose the latter and am glad I did. Before the procedure, even on medication, I could only look out the window in cold weather. Breathing cold air caused huge levels of discomfort and so I was basically house bound for 6 months of the year. Now I go outside and have snowball fights with my family with no problems.

[kenkeith]

Usually, whether to intervene on vessel occlusions requires some knowledge of the degree of occlusion (>70%), whether or not a stent implant can be the best option, is there a positive response to the symptoms with appropriate medication.  

You and your doctor should be aware that opening an occluded vessel(S) for better blood flow.  The hemodynamics as it relates to pressure and blood flow.  By reducing the resistance of a blockage with a stent reduces gradient pressure and has an impact on blood flow through the stented blockage, and gradient pressure at other sites within the network may present a resistance that decreases blood flow through that area.  It is not unreasonable to speculate that the CABG may have had a negative impact on the areas that are now having a blood flow problem.

It would not be proper for anyone other than your doctor and you to make a decision when and how to treat your symptoms.  Generally, it can be said if the occlusions that cause symptoms can be treated with medication that would be the best option.

Thanks for sharing, and if you have any further questions or comments you are welcome to respond.  Hope this helps, take care.