I am a 55-year old male who had a quadruple bypass surgery in 1996, and couple of heart attacks and several stents put in in the last six years. I constantly suffer with acute angina condition. A slight exertion, such as taking shower or changing socks, brings severe angina attack. Two weeks ago, after a angiogram, it was found that I have only one artery open, the rest are all blocked. I am almost bed-ridden. My doctor says, I am not a candidate for a second bypass.
Do you know anyone walking this earth with only one artery open? How long a person with my condition is realistically expected to survive?
How difficult or easy is it, under my condition, to get approved for permanent medical disabilty in the State of Washington? I am on a short term medical disabilty.
There are 4 major heart vessels...LM (left main), LAD, ICX and the RCA (right coronary artery). If any of these vesselds are blocked there would be ischemic (lack of blood) to the heart cells causing heart cell damage, resulting heart wall movement impairment and then heart failure. Any blocked coronary arteries and for survival of heart cells requires blood/oxygen, and sometime there is a slow process where the system develops collateral vessels that provide a natural bypass. Collateral vessels may provide less blood/oxygen to the deficit area causing angina...I have 100% blockage of the LAD.
Or the blockage is to the distal portion of the heart and heart wall movement doesn't have a significant role for effective pumping of the blood into circulation.
Disability, generally, is based on the heart's ability to effectively pump blood into circulation. The measurement is calculated by an echo and reported as EF (ejection fraction) and that calculation is the amount of blood pumped into circulation with each heartbeat. If the EF is below 29%, it is considered heart failure, and if medication or an interventional procedure is ineffective there will be shortness of breath, angina and easily fatigued causing a disibility to do normal activities or work.
It is difficult to estimate a survival time and depends on many variables.
Thank you, Ken keith. Your response was of great help.
I am considering to obtain a second opinion regarding the second bypass surgery. The daily angina attack and the resulting physical weakness is becoming unbearable. The risk of the second surgery would be worth taking.
You could ask your cardiologist whether having a TMR or PMR procedure done is advisable in your situation. This procedure involves using a laser to create 20-40 channels in your heart wall. Studies have shown that it relieves angina in patients where stenting and bypass are not options anymore. You could google TMR and get some info on this procedure.
Like you, bypass and stenting are no longer options for me because of severe CAD of my coronary arteries. I also have only one left open. Fortunately, I have corollaries that have developed that provide enough blood flow while at rest and with very light exertion.
I meet with a surgeon next week to get the results of tests that were done to see if this procedure will work for me.
TMR (trans-myocardial revascularization) is generally done at the time of CABG and PMR (percutaneous trans-myocardial revascularization) is done through a small incision in the chest wall. There are risks involved that you can read about on the internet.
Another procedure is the ECP procedure. This involves going to a clinic 7 days a week for 5 weeks for an hour. They put blood pressure cuffs on your ankles, legs and around your hips. These cuffs fill and relax in time with your normal heartbeat. They act like balloon pumps. The benefit is that they help your body form new corollary vessels. I was recently tested for this procedure but couldn't have it done because of some aneurysms that were over the size limit.
All of these procedures have shown positive outcomes for people in our situation.
There is a procedure called Enhanced External Counterpulsion (EECP) as the poster suggests. My cardiologist thought it would be beneficial for me several months ago for revasculation and better circulation.
There is Medicare coverage for those individuals that do not respond to medication. If and when medication fails, then I will go for the procedure. It is a non-intervention option to stents or a by-pass.
As the other poster states there are cuffs that inflate rhythmetically from calves, then to thighs, then to buttocks that is COUNTER to the rhythm of heart beat and monitored with EKG. When the heart is resting, the EECP inflates and deflates when the heart is resting. It has been shown to be effective for about 80% of patients.
You are the ideal patient for the procedure and the positive results include: Having no angina or angina that is less frequent and ledss intense, having more energy, being able to take part in more activities of daily living with little or no angina or heart failure symptoms, enjoying a better quality of life and having a more postive outlook. At the time of the discussion with the doc, he stated a recent patient was able to play several rounds of golf without any issues.
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