Mom is 76 & went to NYPH 2002 after angio for CABG(on-pump)replacing 2 art(mamm&saph) and aortic valve(bovine).She has lupus (controlled).In '97, she had splenectomy to remove lupus platelet problem. She has Greenfield filter for clot found in her left leg. One TIA estimated at 28 yrs ago.She has carotid artery disease (left mild;right moderate. June '05 echo and nuclear stress found: 1-Mitral-leaflets appear tethered consistent with myocar or papillary muscle dysfunc, or annular dilatation.There is mitr annular calcifi.The left atrium is dilated for size. Severe mitral insuff. 2-Aortic Root and Valve
CT angiography is not 100% proven to image coronary artery bypass grafts and still has some minor problems at this stage of its development. However, if the graft wasnt seen it may be occluded which can sometimes happen after surgery. The only way to know 100% would be to do a catheterization. If there is ischemia on the stress, this would be the next step.
2.Can she have min.invasive bypass or valve replacement? Risks?How soon?
Generally not as a second open heart procedure. From what you report, there would be no reason to replace the valve. She may be able to have any blockage found in the artery taken care of with percutaneous intervention.
3.If we do nothing -chances and timeline for survival? Precautions&signs?
Impossible to answer without knowing you and examing you myself.
4.Candidate for laser revasc or VAD? Are these maj surg too?
Again, a left heart catheterization would show you what her coronary anatomy is. She may not need surgery at all.
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