Failed bypass

  I underwent my second bypass surgery to replace a valve in July of this year.  My first bypass was in 1987.  During the operation, they also redid two bypasses, one of which they used a leg vein to the left coronary artery.  I have been recovering great until 2 weeks ago when I began to feel chest discomfort and back pain on exertion.  The one vein to the coronary artery is failing.  I would like to know if there is any procedure that can be used which will not require another bypass surgery.  I don't believe I would survive. I am a 61 year old male and desperate for help.  If it continues to progress, I will surely have a major attack.  Please help me if you can.

[CCF CARDIO MD APS]

Dear Ron,
I agree completely with you that the bypass to the anterior part of the heart is
of the utmost importance, and those who lose this one, do not always die, however their life
can become miserable in  the form of heart failure which occurs when the heart muscle is weakened
all over from multiple heart attacks or simply insufficient blood flow.
At cardiac catheterization, when the dye is put in the vein graft, a picture is
taken and depending on the extent of the disease in the graft the cardiolgist can attempt
to clean out the graft, especially a new one.  There are some other new procedures for those who are
deemed non-surgical candidates (such as angiogenesis or TMR),  discuss all the options with your cardiologist
and if necessary and possible (per the surgeon) the best option might be another bypass.  There are surgeons
at big centers like the Cleveland Clinic who will do a smaller chest incision if all that is necessary is that
the front wall artery be bypassed- this is something that should be highly considered in your case b/c your valve
is fine, and the only problem is the bypass in front as you state.  One more important point is that WHY are they
not using an artery to bypass the artery in front(called the LAD)?  Arteries last much longer than veins from the leg, and
are usually taken from inside the chest wall-I can not stress enough how important this point is for you.
If you would like a second opinion at the Cleveland Clinic, simply call 1-800-CCF-CARE and ask for an appointment with one of the
cardiologists at desk F-25, for a second opinion on your coronary artery disease.  Regardless, your second opinion is not only very
important to your overall survival as a heart patient, it should come from a surgeon and cardiologist who is highly experienced in
complicated cases such as yours.  Good Luck.
Information provided in the heart forum is intended for general medical informational purposes only, actual diagnosis and treatment
can only be made by your physician(s).