100% LAD occlusion

[akverma66]

I am 47 years old and had undergone By pass surgey in 2004 (4 grafts) . Now, out of the four grafts done one graft - LIMA to LAD graft has been 100% occluded and  supply of blood through the other 3 grafts are very good. My cardiologist has suggested to be on medication as angioplasty /stenting is not possible/advisable to be done on the LAD blockage. I have no symptoms of angina and EF is 45%.
Also, my surgeon has advised to be on medicine only as my condition now, doesn't warrant any surgery due to effective functioning of the other 3 grafts.
Kindly, advise whether i can continue with the medicine or should i have to go for surgery.

[ed34]

Not everyone is suitable for bypass surgery and there a fairly significant number of patients who find the grafts fail for one reason or another. With your EF at 45% is it because you have heart damage? or there isn't enough blood flow through the coronary arteries? If through damage then I certainly wouldn't want to give any opportunity for this to get worse if possible. Now, ONE cardiologist/hospital has told you that opening the blockage is not possible. They should not say this and should be saying "WE don't feel confident in doing it". I have experienced this. I had several hospitals tell me "nothing more can be done" so I approached a teaching/research hospital. I met with a Cardiologist who trains others and his opinion was "I can open that blockage with my eyes closed". I had the procedure done and the blockage was removed with 5 stents. If I was in your situation, I would want a second opinion from someone with far more experience in dealing with total blockages.

[rajiv0207]

cardiologist can try to reopen LAD block. you can continue with the medicine. if symptoms appear go ahead with redo CABG.