Spontaneous Dissection LAD > Cardiomyopathy?

My wife in 2004 had a MI as a result of a spontaneous dissection, no alcohol, drugs, cholesterol at was 120. The surgeon that did her bypass made a comment to me that all her arteries were in good health, but the artery seemed to shrink pass the point of the dissection. He felt it was a birth defect. We were blessed by a good ER that quickly diagnosed the MI. She had a single bypass the next day. Up until 2007 she regularly saw a cardiologist. All her test were good, EF over 50%. We moved and the assumption was the bypass was working and she would not have to see a cardiologist regularly but just follow up with family physician.

In March  this year she bugged the family physician to have run further test to check on everything, no symptoms. He did an echo and her EF was 35%-40%. He referred her to a cardiologist , cardiologist had a MUGA and just did a heat cath last week. The heart cath shows that the bypass has not failed but is functioning but the point pass the bypass has shrunk (atrophy sp?) but the muscle tissue has scarred over and not pumping, it is no longer effective.

It seems the bypass has ultimately proven to be ineffective.

With her bp under control, meds of Coureg, & plavix with bp meds, diet restriction on sodium, exercise  at the age of 43. Is it realistic to expect to see a reversal of the remodel that has apparently occurred since 2007?

The cardiologist is suggesting we consider a defibrillator. We are very unsure of the benefit of a defibrillator at this point. Is a defibrillator a something we seriously need to consider; is it realistic to wait a few month to see if we can see a reversal?