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SINGLE VESSEL DISEASE
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SINGLE VESSEL DISEASE

I am 50 years male Non diabetic/ Nonalcoholic / No Smoking. My TGL were found on higher side for past 6 to 7 years and doctors recommended Rosuvas 10 mg for the same. Till date I am walking 6 to 7 Km.(Fast) and I can climb 4 story building without any break.  Till date I do not have any angina pain or any other chest pain. On 10.05.2012 I went for a full Cardiac check up.  During my tests my TMT was found Mild Positive and my TGL was 280 mg/d1.  There after Doctor recommended for CAG. My CAG was done on 16.06.2012 and on 30.06.2012 doctor recommended Coronary CTA.
My CAG Report is as under :-
Left Main Coronary Artery :- Short, Normal
Left Anterior Descending :- Proximal LAD - has critical eccentric lesion followed by total occlusion after - S 1 - retrograde filling on RC injection.
Left Circumflex :- ? Dominant , Normal including OM'S
Right Coronary Artery :- ? Non dominant, early bifurcation retrograde illing LAD, normal
LV Angio :- Not Done
Impression :- Single Vessel Disease
Management Option :- 1 PTCA to LAD  (2) CAGB
Medicines Recommended :- Nesicard 50mg & Atrovit

My Coronary CTA report :-

Opacification :- Satisfactory opacification with adequate timing
Cardiac chambers are normal in size . No obvious congenital anomalies.
Calcium Scoring (Agastson( 69.50
Dominance :- Right
LMCA :- Normal in caliber. No obvious intimal plaques.
LAD : mixed plaque. Severe disease with total occlision at proximal 1/3 proximal to D1.
D1 :- Mild to moderate disease to origin
D2 :- Mild to moderate disease at origin.
LCX :- Non dominant. Normal in calibre. No obvious intimal plaques.
M1 :- Large vessel Normal
M2 :- Large vessel Normal
RCA :- Normal in caliber. No obvious intimal plaques.
AM. Normal in caliber. No obvious intimal plaques.
PDA & PLVB :- Normal.
Myocardium & pericardium :- No obvious abnormality.
Extra / Non Cardiac findings :- Nil Significant.

My doctor ruled out the possibility STENT implant. and advised me not to go for any surgery. He advised me to take regular prescribed medicines.

On 23.08.2012 & 24.08.2012 I had an opinion of Two different  senior Doctors. As per their advices I am on high risk and asked me to go LAD grafting immediately.

Please advise.
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976897 tn?1379171202
I agree totally with your cardiologist. I would forget the bypass surgery. The thing is, you have a good bypass already, one that nature has given you. Your right artery is feeding the left artery. Believe me, because you have no symptoms, I would leave it alone. If you have bypass surgery, those natural bypass vessels could close, and you could end up feeling worse. Bypass vessels done by surgery can fail, mine lasted 3 months. If the bypass fails, there is a chance that the natural ones will not re-open. I would listen to your cardiologist and use medication/healthy diet to keep going. Your blockage in the left artery has probably been there for many years, yet nature has done it's job perfectly and you was unaware. If something is working, leave it alone, you could make things much worse by interfering.
976897 tn?1379171202
I agree totally with your cardiologist. I would forget the bypass surgery. The thing is, you have a good bypass already, one that nature has given you. Your right artery is feeding the left artery. Believe me, because you have no symptoms, I would leave it alone. If you have bypass surgery, those natural bypass vessels could close, and you could end up feeling worse. Bypass vessels done by surgery can fail, mine lasted 3 months. If the bypass fails, there is a chance that the natural ones will not re-open. I would listen to your cardiologist and use medication/healthy diet to keep going. Your blockage in the left artery has probably been there for many years, yet nature has done it's job perfectly and you was unaware. If something is working, leave it alone, you could make things much worse by interfering.
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