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Please advise is it wise to have medication and no angioplasty or CABAG? specially in my case..
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CORONARY ANGIOGRAM
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Catheter procedure:

Through right femoral artery. Seldinger 6F catheter passed to arota and LV. LV arotic pressures and LV angiogram recorded.

Left and right Coronary Angio done with judkins Coronary Catheter no 6F.

Angiocardiogram Report:

LCA      LMS:    Normail

LAD: Subtotal occlusion at mid course. Subcritical osteal disease in D1 and D2.

LCx: Moderate disease at mid course and in major OM.

RCA:          Dominant. 90% critical diffuse disease at mid course.

LV Angio:  Anteroapical severe hypokinesia. Impaired LV function.

Diagnosis:  TVCAD with impaired LV function.

Advised: PCI to RCA and LAD after viability scan.
                CABG surgery after viability scan.
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MYOCARDIAL SPECT PERFUSION STUDY
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Indication:

H/O MI in 2007- planned for CABAG/PCI toRCA and LAD. For viability and inducible ischemia

Stress:

Dipyridamole was infused coupled with low level excercise without any significant complaints and ischemia ECG changes. heart rate changed from 68 to 100/min and blood pressure from 130/80 to 140/90 mm of HG.

Findings:

Images acquired after stress injection of Tc-99m-MIBI showed markedly reduced to absent tracer uptake at apex,antoseptal wall,apical anterior segments and almost whole of the inferior wall. After resting injection there was no change appreciated in the defects noted during stress study.

Conclusion:

1) No evidence of any peri-infarct/residual stress induced ischemia.
2) Fixed perfusion defect at apex,antroseptal wall,apical anterior segments and almost whole of the inferior wall showing no sign of viability scan. All other segments are viable including mid and basal anterior wall,IVS and lateral wall.
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These are the angiography and viability scan reportf my father... We consulted one of famous suregeons here and he says that my father can not have CABAG nor angioplasty and should be kept on medicine. Angioplasty will not improve his condition significantly. However, angioplasty specialist say he shld go for angioplasty and will be having 3 stents... Please advise in the light of these reports as what should we do...Thanx in advance
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