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Heart Disease (Expert Forum)
Re: Bypass Surgery Concerns
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Re: Bypass Surgery Concerns
by Gary__0, Jan 01, 1995 12:00AM
Posted By Gary on July 26, 1999 at 14:30:39
First, thank you for this service. In the healthcare field, one can never have too much information.
I will be 51 in Sept 1999. In June 1998, I saw a cardiologist for angina. I took a stress test, and was told I probably had some blockages but an angiogram wasn't worth the additional risk. I was given a different med for my hypertension and a follow-up appointment for December 1998. The December appointment was uneventful.
On May 14, 1999, I awakened with stroke symptoms (right arm/right leg), went to the ER, and was admitted to Holmes Regional Medical Center. Over the next six days I had a number of tests including an angiogram. My cardiologist gave me the bad news about my angiogram results and showed me the x-rays in the cath lab. The report's conclusion reads:"Severe multivessel coronary artery disease including left main coronary artery disease, totally occluded LAD, totally occluded obtuse marginal branch, totally occluded right coronary artery with multiple intracoronary collaterals providing distribution...." I was told to wait 3-6 weeks (due to the stroke) and then schedule CABG surgery.
Other than a return to the hospital to remedy a pseudo aneurysm caused by the angiogram, I feel fine. I am taking Coumadin, Accupril 20mg, and Lipitor 20mg (last results: LDL=75, HDL=32, CHL=153, TRI=231). I feel well and try to walk at least a mile every day. As long as I avoid strenuous activities, I don't have angina.
I am having trouble coming to terms with scheduling my surgery. I can't discuss this with my cardiologist. He is exasperated with me and probably close to turning me lose.
QUESTIONS:
1. Am I in immediate danger of having a heart attack due to my procrastination in scheduling the bypass surgery?
2. Will having the bypass surgery help prevent me from having a heart attack?
3. Because of my recent stroke (with nearly full recovery), I am concerned about the possibility of having a stroke during the surgery and ending up in even worse shape. What can be done to help prevent a CVA during and immediately following the surgery?
4. Can anything be done to mitigate the risk of not being on bloodthinners for several days during and shortly after the surgery?
First, thank you for this service. In the healthcare field, one can never have too much information.
I will be 51 in Sept 1999. In June 1998, I saw a cardiologist for angina. I took a stress test, and was told I probably had some blockages but an angiogram wasn't worth the additional risk. I was given a different med for my hypertension and a follow-up appointment for December 1998. The December appointment was uneventful.
On May 14, 1999, I awakened with stroke symptoms (right arm/right leg), went to the ER, and was admitted to Holmes Regional Medical Center. Over the next six days I had a number of tests including an angiogram. My cardiologist gave me the bad news about my angiogram results and showed me the x-rays in the cath lab. The report's conclusion reads:"Severe multivessel coronary artery disease including left main coronary artery disease, totally occluded LAD, totally occluded obtuse marginal branch, totally occluded right coronary artery with multiple intracoronary collaterals providing distribution...." I was told to wait 3-6 weeks (due to the stroke) and then schedule CABG surgery.
Other than a return to the hospital to remedy a pseudo aneurysm caused by the angiogram, I feel fine. I am taking Coumadin, Accupril 20mg, and Lipitor 20mg (last results: LDL=75, HDL=32, CHL=153, TRI=231). I feel well and try to walk at least a mile every day. As long as I avoid strenuous activities, I don't have angina.
I am having trouble coming to terms with scheduling my surgery. I can't discuss this with my cardiologist. He is exasperated with me and probably close to turning me lose.
QUESTIONS:
1. Am I in immediate danger of having a heart attack due to my procrastination in scheduling the bypass surgery?
2. Will having the bypass surgery help prevent me from having a heart attack?
3. Because of my recent stroke (with nearly full recovery), I am concerned about the possibility of having a stroke during the surgery and ending up in even worse shape. What can be done to help prevent a CVA during and immediately following the surgery?
4. Can anything be done to mitigate the risk of not being on bloodthinners for several days during and shortly after the surgery?
Related discussions
Dear Gary,
You do have severe coronary artery disease with blockage of the left main artery which, as the name implies is the artery that serves over two thirds of your heart.
1. Am I in immediate danger of having a heart attack due to my procrastination in scheduling the bypass surgery? Yes, you are at increased risk due to your anatomy. We generally directly admit someone like you and perform surgery ASAP.
2. Will having the bypass surgery help prevent me from having a heart attack?
Yes, that is the idea a bypass is available, should you native artery decide to shut down over time.
3. Because of my recent stroke (with nearly full recovery), I am concerned about the possibility of having a stroke during the
surgery and ending up in even worse shape. What can be done to help prevent a CVA during and immediately following the
surgery? It would be important to have the cause of your stroke determined ( is it a blockage in your carotid arteries (an ultrasound study can sort this out) or is it from a clot from your heart or other area in your body or is it from increased blood pressure and a bleed. Each can easily be addressed at the time of surgery. In fact you may consider a combinded carotid endarterectomy if your carotid is blocked. Although I would only recommend this at an experienced center.
Please do have your surgery. We are here to help protect your heart and you have the opportunity to prevent a very likely heart attack from happening if you proceed with surgery in a sppedy fashion.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. If you
would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by
using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology
staff that can be used to select the physician best suited to address your cardiac problem.
Thank you so much for your quick response.
I guess I am having trouble with scheduling the surgery because I feel well. I am reasonably certain I went through the stress test in June 1998 in about the same shape I currently am in. I know this surgery has a long recovery. I have only talked with people who had no choice--they couldn't live any semblance of a life without the bypass surgery.
My carotid arteries are clear. Both my cardiologist and neurologist believe the stroke was caused by a piece of plaque from the heart arteries. Their assumption is based on MRI results.
I have a very extensive network of collaterals providing blood to my heart. I hope they will still be with me after the surgery.
"The left main coronary artery showed a 60-65% stenosis distally prior to its bifurcation into the LAD and left circumflex." This is from the angiogram report.
I didn't understand your comment to my 2nd question. The arteries are already 100% occluded.
I spent 21 years in Ohio--I rather wish I was still there to go to the Cleveland Clinic. But, the surgeons from the University of FL are supposed to be pretty good.
I will get off the dime and do something about this. I'm a little beyond the Ornish program.
Thanks again.
I will get off the dime
Dear Gary,
Glad to hear your carotids are normal.
In general, although your heart arteries may be 100% blocked in one area there are often large areas of other arteries that can be bypassed. Your LAD has major branches called diagnonals that may be compromised by your Left main blockage. In addition there is a large vessel, the circumflex that arises from the left main trunk that is compromised . It is assumed that these vessels serve viable tissue and would benefit from a bypass.
I wish you the best of luck!
Please - Take care of yourself. My father was 100%, 85%, 80%, 80% on all four arteries....he was procrastinating and we could have lost him.....He is 12 weeks post op and is swimming, walking, and happy.. God Bless You.
Dear gtt.
thank you for your comments I too hope that Gary has these blockages addressed.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own
doctor. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call
1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart
Center website contains a directory of the cardiology staff that can be used to select the physician best suited to
address your cardiac problem.
I appreciate the additional comments and concern. I am requesting a second opinion next week. Bonita (my wife of 32 years) and I walked two miles on the beach today, and I am working every day except Sunday. So, I am still feeling pretty good. Nevertheless, I will not start my 51st year (13 Sep) with this unresolved--either to have the surgery or not. It is disconcerting to ask my surgeon his personal mortality rate and hear a number more than double the .5% stated by the Cleveland Clinic. Darn. I do appreciate the comments and this service.
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