Heart surgery - bypass

[lone217]

My husband underwent a heart bypass in October last year. Almost immediately after the surgery, when he returned from hospital he experienced (cold weather) angina-like pressure on the chest. In March, this year, he was checked by the hospital doctors (had his bypass veine checked - I do not know the English word for it) and they found out that the bypass vein had closed down due to the blood pressure in his "old" veines was higher than in the bypass.  He had no extraordinary medical treatment after this. My question is: If his health situation worsen can the bypass vein be re-opened or will he have to undergo a new bypass with new bypass veins?
Kind regards
his wife, Lone

[ed34]

My left artery was re-opened using angioplasty, 5 stents. It was said this was impossible by every hospital I visited, and then I tried a research/training hospital which I was told had all the real experts.
There is also ECP which can encourage collateral vessel growth. The heart has to meet specific criteria for this treatment, which a cardiologist will be able to explain.
Although many times, angioplasty is shelved in preference for bypass, usually due to the number of stents and work that would be required, it is not impossible.
I was put on medications but these did very little for my symptoms. Nitrates did nothing for my angina and only gave me severe headaches. Medication doesn't work for everyone but it's always worth trying as a first measure.

[Doug278]

I am in the same position having 3 of my 4 grafts blocked and the reason given for the LAD CABG blockage was better flow to the native artery. This still needed attention due to the level of blockage before the grafts. My Cardiac consultant advised me that in some circumstances a catheter with a laser can be used to clear artery blockages but this was not suitable for me. It's true that Veins are not as suitable for grafts as native arteries which is why the first choice for graft is the LIMA (Left Internal Mammary Artery) which is almost always successful.
My health has not improved with the CABG and since the operation I have had several stents, some of which are in the grafts and one is inside another stent. I have a range of medicines which help to a degree so the options seem to be there.
I hope this gives you some comfort

Best Wishes

Doug

[lone217]

Dear ed34
Thanks so much for your quick answer. No, angioplasty has not been mentioned. Are there different methods of angioplasty?

I am not even sure it would be possible afterall, it also depends on the native arteries' condition. Can I suppose the cardiologist would had mentioned it, if it was possible? His native veins are  blocked to some extent, we were told, however, the blood pressure is higher than in the graft. The cardiologist also mentioned that the minor "pressure" in the chest may be physically in somw way. We are a bit confused, I must say.
May I ask you - since  your "new" vein (they removed native vein from my husband's leg as graft) lasted three months, are you treated medically instead or otherwise? have your doctors suggested a new operation?

[ed34]

I'm not really certain what the cardiologist is trying to say here. If there was sufficient pressure in his (old artery = native artery) then there was no need to bypass anything. It is not uncommon for bypass grafts made from Veins to close up. Mine lasted three months. Veins are known to be weaker than arteries but the full reasons for closure is not generally understood. In some patients they last 20 years or longer, while others can last a matter of weeks. If the Veins have collapsed, then it is usual protocol to class the patient as unsuitable for grafting and other options have to be considered, such as different methods of angioplasty. The Veins will not re-open. His condition will only worsen at this time if the disease increases and restricts blood flow further. Have they said anything about considering angioplasty procedures to improve his condition?