Blockages in artery vessels

[ribinarotha]

My father 61 years old recently had angiogram. The conclusions were as follows.
LMCA : 4.0mm vessel and has ostial 30% stenosis.
LAD  : Type iii, 2.5 mm vessel. Proximal LAD has 50 % stenosis. Mid LAD has 90% stenosis. Distal LAD has long segment 90% stenosis. terminal part of LAD is normal and is graftable. D1 small calibre vessel. D2 is 2 mm vessel and diffusely diseased.
LCX : Dominant 3 mm vessel. Ostio proximal LCX has 40% stenosis. Distally normal. Major OM1 is 2.5mm vessel and has ostio proximallong segment 80-90% stenosis. LPLV is 2.5mm vessel, normal. LPDA is 2mm vessel has proximal 90% stenosis.

He is on treatment for sugar & BP for many years. Anyone please advise what treatment will be better for my father for his blockages.

[ed34]

I have to be honest and say I'm a bit confused with the decision of bypass. For example, the LAD is an important vessel and it's diseased at the top, middle and bottom. Now, to get a good supply into this vessel, exactly where would you bypass to? It does say there is a clear area right at the bottom, but what's the point in that when the blood can't get up to the diagonals? The supply to the diagonals are restricted by a 90% blockage in the LAD halfway down. Your vessels seem quite small too, your LAD is only 2.5mm which is the minimum that stenting can handle. The Diagonal 2 vessel is only 2.mm which is too small for stents.
There is also an artery at the back requiring bypass (90%) and this is always the tricky one to reach.
If the Doctor is a bit concerned about bypass, then I would look to other options. Is this a major heart hospital?  Even your Left Circumflex has an ostial occlusion of 90% and this is a dominant vessel, important for giving out collateral feeds to the LAD etc.
I don't think personally that your case is a simple 'either/or'. I think you require a mixture of angioplasty and MAYBE bypass.
If this was my heart, I would put a proposal to the cardiologist. They obviously think that there are too many stents required, and they obviously are doubting bypass. I would suggest to have 3 stents. One to the middle of the LAD. One to the ostial Obtuse marginal 1, and one to the posterior descending. Then I would see if you develop some nice collateral vessels to open across to the distal LAD and Diagonals. I don't see what they hope to achieve with bypass, there are too many blockages and no matter where they graft, it won't give a supply to all the left side of the heart.
The only blockage which looks a bit worrying for stenting is the ostial of the Obtuse Marginal 1. However, there are techniques for getting good results in such areas these days using angioplasty, it's just a matter of finding someone with the experience needed to perform the procedure.
You don't have to worry about 50 or 40% blockages (yet).

[ribinarotha]

Bypass is suggested......Doctors also says there is no other options....but he is little scared of Bypass.

[Flycaster305]

What treatment is planned for your father in view of his diseased vessels?  

The word 'Distal' suggests that he has blockages where the large arteries branch off, and stents are seldom inserted in these locations.  Blockages above 70% are considered serious.  

Certainly, diabetes and blood pressure control is essential.  Has bypass surgery been suggested?  It appears from the report that bypass is an option.  I'm not a health professional, but if bypass surgery is recommended, I'd seriously consider it.