Bypass Artery Blockage

A heart catheterization was performed on me on 1/20/2000, which revealed that I have a blockage of one of my heart bypasses done 13 years ago. Before the catheterization I was in pretty good health and could exercise and swim in the pool at the local athletic club. Now I have become very limited in this respect.

I subscribe to the Cleveland Clinic Heart Advisor. In the July issue, enclosed, is a discussion by Dr. E. Murat Tuzcu which indicated that you, The Cleveland Clinic, may have developed a procedure which could clear a blocked artery. In view of the fine reputation of the Cleveland Clinic in developing new ways to correct heart defects or deficiencies, I am hopeful that you may have a solution to my problem.

Could you please inform me as to the possibility that you or any other facility (close to Florida) has the expertise to clear the block in my saphenous vein graft #4?

I thank you for anything you can do to help me.

Jack

[Cleveland Clinic, MD]

Dear Jack,
Opening blockages in bypass grafts can be a tricky business.  It would first depend upon the degree of blockage.  A completely occluded bypass graft can not generally be opened unless the occlusion is very fresh.  There are other problems associated with partial blockages:  The grafts are fragile and prone to dissection; the blockage material can flow downstream and cause heart attacks; there is a high rate of restenosis in bypass grafts.  However, we do perform angioplasty in some cases.  

There are many new techniques being developed here and I'm not sure exactly which one Dr. Tuzcu was discussing.  We offer these new therapies as parts of protocols if the patient meets the inclusion criteria and is willing to be a part of a study.  The Flordia branch does not have as many research protocols as the main campus here in Cleveland does but still provides quality clinical care.  

So I think you best option would be local evaluation and if they are unable to offer solutions to your problems then to travel to Cleveland for an appointment with Dr. Tuzcu.  Best wishes.

[Mike501]

Does anyone know what to look for in EKG in order to distinguish causes of LVH if only two options are considered  a) coronary blockage or b)mitral regurgitation ?
I heard that there are EKG changes which are specific
only to mitral regurgitation and that there are EKG changes which are specific only to coronary blockage.In turn both can cause LVH.
George