Failed Stents

[Kiwi01]

Dear Doctor:

Late last year I had two angioplasties and stents implanted.  Less than three months later, one stent was almost completely plugged and the other about half.  They then did bypass surgery since the doctors didn't feel they could clear them.  I have several questions:  

1. What likely happens to these stents? Do they continue to plug up completely? Can they clear themselves up or is there some way to clear them?  

2. Can the stents be removed and is there benefit to doing so?

3. Having had failed stents does this make it more likely that future stents (if needed) may have this same problem?  

4. Do failed stents argue that an angioplasty without stents would originally have been a better option?

5. If the bypass were to close up would it be better to do angioplasty with or without stents given this history of stent problems?

Thank you much for your forum and your advice.

[CCF CARDIO MD - DLB]

1. Yes, the stents will likely continue to get plugged up, but in your case that may not matter much, since you have bypass grafts. They will not clear up on their own and the only way to clear them up is with repeat angioplasty.
2. No they cannot be removed.
3. Yes, it does increase the likelihood that future stents will get plugged up.
4. No, stents generally increase the success of angioplasty.
5. That depends on where the blockage might be and specific characteristics of the blockage and what happens during the angioplasty procedure. Those decisions would need to be made by the cardiologist at the time of any future angioplasty.

[Paul]

I too had angioplasty in 1997, i had two stents put in, one year to the date after i had the angioplasty, i was having open heart surgery,they clained the stents caused a dam to build up, resulting in the triple by-pass.I have heard that having these stents put in is a complete waste of time, my aunt had them last year, she is now having chest pain again, im just as confused as you about this, can anyone clear this up?

[John Mc]

I too had 4 stents done during 5 diferent angioplasties over a period of 1 year. They actually inserted 1 stent inside of another after the original collapsed to reinforce it with a double wall and it too ended out failing. I have since had bypass surgery (2 years ago) and everything seems fine.  I'm only 44 years old and obviously wonder whats next.  

Since the surgery I've been on Metoprolol and find myself to get very sweaty and short of breath (no pain) with just the slightest exersion of working around the house. I was wndering if anyone else on this medication or after heart surgery has similar problems?

Hope this is informative and thanks for the help

John

[Paul]

This reply is to John, after i had my open heart i was put on Toprol xl, i was having the same kind of symptoms as you, feeling weak and sweaty. The Dr took me off these meds altogether, i to am a young man, i had my open heart at 44, and im in a constant state of fear waiting for the next problem, so you are not alone, open heart causes tremendous anxiety, and the effects are felt long after the surgery, both physically and mentally, i wish you luck in your battle, im sure in time all will fade, and you will return to normal again.

[John]

Responding to Paul

Paul thanks for your response. While you where on Toprol xl did you find that you huffed and puffed with minimal exersion but yet could excercise with no problem at all?  I find I can excercise but if i'm working in the yard bending over or lifting and carrying boxes I end out huffing and puffing enough to cause me to stop. There is no pain involved.

The anxiety portion of this is really no problem, I feel relatively comfortable with what happens - happens. It has been 2 years since surgery but I certainly don't feel normal.

Thanks again for your response, its good to be able to talk to someone in the same age group about a common situation. Unless you've been there its hard to understand.

John

[John]

Responding to Paul

Paul thanks for your response. While you where on Toprol xl did you find that you huffed and puffed with minimal exersion but yet could excercise with no problem at all?  I find I can excercise but if i'm working in the yard bending over or lifting and carrying boxes I end out huffing and puffing enough to cause me to stop. There is no pain involved.

The anxiety portion of this is really no problem, I feel relatively comfortable with what happens - happens. It has been 2 years since surgery but I certainly don't feel normal.

Thanks again for your response, its good to be able to talk to someone in the same age group about a common situation. Unless you've been there its hard to understand.

John

[PATTY]

This is interesting, because i also noticed the same thing after starting on toprol XL.  i am taking it for palpitations, and i was taking 100 mg/day.  I was short of breath with minimal exertion and being only 37, i am still quite active, and found i could go out and shoot a game of basketball and not experience this shortness of breath.  I slowly decreased my dosage down to 25 mg/day (with the advice of my cardiologist)and found the shortness of breath along with the lethargic, sleepy feeling i was having subsided.  And most importantly, my palpitations are still under control.

[John]

Patty thanks for your reply, I was originaly on 20 mg a day for palpitations and a fast heart rate to the point that it was uncomfortable and tiring after a while.  My cardioligist then boosted me to 40 mg a day and it relieved all my symptoms except for the occaisional bout of palpitations.

It is strange because as you said I can excersize without an discomfort but the moment I carry a box upstairs or bend over working in the garden light shoveling or raking leaves I huff and puff until I have to stop to take a breath. The other strange thing is it makes me sweat profusely wether I'm working or not( but especially while I work). I too find that I get tired very easily and have to sleep alot.

Maybe its something we have to live with but at least its comforting to know that I'm not alone. (Not to wish discomfort on anyone else!!)

Thanks again
John

[Ron]

I too had angioplasty last August and had 2 stents implanted.  I am a 47 year old male.  My cardiologist stated that my risk factor was my cigar smoking. ( I inhaled 3-4 cigars per day.) I am a little nervous after reading the previous messages from folks that have had stent failures.  I believe that if I stop my cigar smoking, which I have, that I should expect to make a nice recovery without the need for another catherization in the near future.  I have also experienced some minor shortness of breath. I too am on 100mg of Toprol XL.

[cutefrog]

To all the young men who had heart surgeries, and other cardiac procedures.  My husband was 32 and had bypass surgery after suffering two heart attacks.  (they were treating him for stomach ulcers thinking all his pain was due to ulcers.)  Anyhow, he had 5 1/2 bypasses done--don't ask me how they came up with the 1/2, but that is what the doc. said.  All he takes now is one baby asparin a day and plendil for blood pressure.  When he went in and had a wire cath. done ten years later, the doc. said the graphs were as clear as a bell, and just looked like they were just done. He has been taking the omega 3 fish oil everyday since his surgery 16 years ago.  The docs. told him  to keep on doing whatever he has been doing.  It may be something for you to think about.  There has been a lot of good studies on the good results from the fish oil.  Just thought you all may like to know.  Oh, don't forget to skip on the double meat whoppers too.

[Kiwi01]

Question for froggy.  Does your husband not take any cholesterol lowering drug? How much omega3 a day does he take?  Way to go.  It's great to hear success stories like your's.  Thanks.

[John]

This is to Ron & Froggy, I too have heard that fish oil is extremely good for you. I've been told the more fish you eat and the oilier the better (that being natural fish oil not fish and chips!).

Ron they say that 30% of all angioplasties fail within the first 6 months, but once your past that your chances get a lot better as time goes on so just live right and excersize regular Good Luck.

Froggy thanks for the info, the reason they put me on Toprol XL is to regulate my heart beat so that everything smooths out. I had a resting heart rate of 104 with PVC's that drove me crazy to the point that it hurt. I also take aspirin, a cholestorol lowering med and various vitamins. I too would like to know the amount and type of Omega 3 your husband takes.

Thanks
John