Second cabg or stents

[Hukumat]

For last 2/3 months severe angina.Thalium shows reversible ischemia in inferior wall. Every time ecgs and enzyme are normal .
Had cabg in 1994 svg to diagonal 1, svg to om3 and lima to LAD.RCA not revuscularised as very bad and beaded etc
Had angio done on 15th dec 2009 and it show
50% occlusion ,svg to om3 20 % ocluded and Lima to LAD patent.However lima is stuck behind sternum and at that point is kinked ,flow is good.
Many episodes of Angina ..and chest pains, along with skip beats  and pvc was on following medications
concor 5mg, imdur 60 mg, crestor 20 mg ,asprin 150mg ,BP always was 110/80 and heart rate 52-55
Cardiologist suggest reconstruction of complete RCA by using 4 stents ,and 2 more he wants to put in svg to diagonal.
Medication changes post angio beta blocker with drawn
20mg olmesartan medoxomil
75 mg plavix twice daily.asprin 325mg, imdur 60mg, Ranolazine 500mg twice daily.crestor 20mg.
BP is 120/80 HR 72 .. skip beats still continue with angina or chest pain some times every 4th beat missing or PVC.
I hv had no infarction  EF is still 55% .
Shall go for these stents or I for redo cabg... if cabg which is best place.I live in India but willing to travel any place

[ed34]

The 'beaded' rca is not going to be improved by a bypass because it would take too many vessels. Cleaning it up using angioplasty is a good option. To lower your risk of restenosis, ask them to use drug eluting stents and make sure you take Plavix for at least a year. As they go down the rca continually ballooning it, you will feel some chest discomfort for a few seconds at a time. This is normal and nothing to worry about. I think they will give you strong meds for this procedure to keep you comfortable. I had virtually the same thing done to my LAD in sept09 and it took about two hours. Recovery is nice and quick, I was discharged the following morning.