Heart Disease Questions

  My father has had a battle with heart disease for 18 years.  He is in pretty good physical condition, low blood pressure, low cholesteral, low tryglycerides, stopped smoking, eats properly and still has repeated angioplasties and unstable angina.  He recently had a second stent put in after 8 angioplasties.  He does not get adequate exercise except he still mows his lawn and does heavy yard work.  Why if all of his blood work is always so good, his blood pressure very low, and his diet is good does this problem still exist?  He is in his early 70's and people who see him and are not aware of his heart problems are shocked to know the extent of them.  He is not a candidate for open heart surgery again because his cardiologist indicated that his heart is too damaged.  Are there any alternative treatments for him?  He is in pretty good shape except for his heart.  Could he be examined by the Cleveland Clinic staff for possible treatment.  I heard you have a branch in Ft. Lauderdale.  He lives in central Florida.  I would really appreciate any information about possible experimental treatments for individuals in my father's condition.  Could he participate in any research projects.  Thank you for answering my questions.  It is a wonderful service and I am very grateful for it!

[CCF Cardio MD-SGM]

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Dear Bren,
It is critical to mention that ischemic coronary artery disease is a progressive disorder that is largely genetically determined.  Control of classical risk factors such as you mentioned is very important, but oftentimes serves only to slow this rate of progression.  No cure currently exists.  
If your father has recurrent episodes of unstable angina despite aggressive medical therapy (nitrates, beta blockers, aspirin) and he is no longer a candidate for traditional interventional therapies such as angioplasty or bypass surgery, he may be a candidate for several promising investigational treatments.  The first is gene therapy with a substance called VEGF which stimulates the growth of blood vessels in the targeted area.  Also, a procedure called Direct Myocardial Revascularization creates tiny channels in the heart muscle through the use of a laser, helping to increase blood flow and stimulating new blood vessels to grow.  
We would be happy to evaluate your father at the Cleveland Clinic for this condition.  Please call 1 800 CCF CARE to make an appointment with Steven Ellis, MD at desk F25.  An evaluation at the Florida campus is an option, but the definitive therapies I have mentioned are available only in Cleveland.
Best of luck.  Information in the Heart Forum is for general purposes.  Specific diagnoses and therapies can only be provided by your physician.