Is stenting a solution for Post CABG cases

[AYYADURAI]

I am 56 years diabetic hypertensive...

I had cABG done in september 2008.
In a recent routine review check up , Stress test is positive and My CT angio reveals the following.

..LIMA LAD graft  is patent anastomosis There is no flow in LAD distal to LIMA -LAD
LM-Left main is normal bifurcating into LAD and LCx

LAD  Proximal LAD is normal...Mid LAD shows critical Stenosis  Distal LAD shows Absence of flow to distal LAD-LIMA anastomosis

Diagonal I Is small calibre and shows diffuse disease

LCx shows severe ostial  and proximal stenosis due to calcified Plaque

OM1 Shows ostinal stenosis  however it is flowing well through RIMA graft

RCA   RCA is normal   Mid RCA  shows critical stenosis   distal RCA shows Normal SHOWS CRITICAL STENOSIS

Ascending Aeorta , arch and  descending thorasic Aorta are normal . Both subclavian arteries are normal
LV shows apical Scarring.

Native triple vessel disease as described above.
Patent well flowing SVG PDA Graft with good flow in distal RCA and PDA, PLV.
LIMA =LAD GRAFT IS PATENT TILL ANASTOMOSIS  WITH NO FLOW IN LAD  DISTAL TO ANASTOMOSIS

RIMA-OM1 PLV graft is patent

I am strict in my diet and no habits .. What is the remedy or ur advise plaese....


Kindly revert as early as possible dear....

Regards..
Ayyadurai k.s.

[ed34]

It looks a bit strange to me, as though they have made an error during bypass surgery. Your LIMA looks to have been grafted in the wrong place. It is either directly over an already existing blockage rendering the feed useless, or it has been grafted on the wrong side of the blockage. This is not uncommon, in fact my LIMA was grafted over a large blockage. Ask to see the angiogram images used to plan your bypass surgery, and I bet the blockage is there on the images. It's unlikely it has formed since sept 08. I would ask to speak to someone with a lot of experience in Angioplasty, a Cardiologist in a research/training hospital with a minimum of 20 years experience. You will be surprised what they can offer. If they have grafted your LIMA in error, and they know you are aware of this, they will meet your requests with no problems.
It still amazes me how they can do such things. When then made an incision in my LAD for grafting the LIMA, surely he would have felt/seen a huge solid plaque blockage.