It's been 5 years since CABG

[Peter Wenz]

I have multiple questions.  First, I had a triple (including the LAD) in Oct 94 at age of 44.  Took leg vein for two and flipped something in my chest for the third one. Never had heart attack, and recovery was perfect and complete with no complications.  (Thanks God)  Am on Toprol XL and baby aspirin.  I Excersize three days a week, changed my diet and no longer smoke.

How long can I expect the bypasses to last?  On average, for someone my age.  I've heard of cases where the patient went back to smoking and made no other positive changes, and it's been 20 years.  

If I did suddenly stop taking Toprol XL, what would happen?  Would it cause a heart attack?  Would the negative effects of withdrawal gradually dissappear?  I'm worried about running out with no access to more such as a Y2K problem, or travel to a rural area/country.

[Cleveland Clinic, MD]

Lifestyle changes definately help prolong the life of the grafts but there are still limits.  Veins are not really made for the high pressure of arteries and usually close after 5-10 years with an average of 7 years.  ARterial grafts (e.g. mammary artery) on the other hand can last a long time.  I have seen at least one person with a 20+ year old artery graft that was still wide open.

[Peter Wenz]

If I suddenly stop taking Toprol XL, what would happen? Would it cause a heart attack? Would the negative effects of withdrawal gradually dissappear? I'm worried about running out with no access to more such as a Y2K problem, or travel to a rural area/country.

[Stan]

This is info I got from my doctor:

How long do the bypasses last?

I think I've heard more poor information about this than about any other topic in cardiology. Bypass grafts can last for really long periods of time. I have seen many instances where the graft looks almost "brand new" on angiograms done 15-20 years later.

Bypass grafts do close however. About 50% of the grafts placed are closed in 10-12 years ( that means that if four bypasses were placed in a patient, then 2 would be expected to be closed in 12 years). The ones which do close most often are those that supply smallest vessels, or those which supply the heart muscle with the least amount of need for flow. This makes sense to a great degree - veins are soft structures which can collapse, and if the flow is slow, they may do this early. The patient is generally not aware of this when it happens either since there may be enough flow from other vessels to "make up" for the decreased flow through the bypass.
Again, it is important to take good care of yourself and your bypass grafts. You and they will last longer that way! Recent information regarding the use of cholesterol lowering agents stress this: patients who were given cholesterol lowering agents lived longer with more open grafts.

[Cleveland Clinic, MD]

Dear Peter - Medication issues need to be addressed by your doctor.