Triple Heart Bypass

[buster22596]

I have had a angiogram and have been told that I will need a Triple heart bypass as they cannot use stents because of the position of the narrowing and that one of the larger arteries is slightly blocked. I am not bothered about having the operation but as the new veins only last about 10 to 15 years I dont know weather to wait as I can still work and walk ok at the moment I just get tightness in the middle of my chest and angina pain if I run.  I am taking lots of vitamins like c and l-proline, l-lysine , omega3 and q10 do these help or work in any way to help the heart desease has anyone used them and should I wait to have the bypass till I can no longer wait and how long do the veins last before clogging again

[buster22596]

Thank you for your reply I have a consultation with my heart consultant and I will see what he has to say but I would rather not have the operation unless I have to and then get him to use the internal mammary arteries if I have the bypass,
I am just glad I never had any stents fitted as have had bad reports of them.
Has anyone ever tried using vitamins etc to help with the heart condition. Vitamin C, Omega 3, L-lysine, q10 and L-proline are all very good for the heart. Also a glass of alcohol everyday especially red wine is good for the heart it opens up the arteries, thins the blood and increases good colesteral and reduces the bad.
I would like the chance to try the above first instead of having the operation straight away.
Also I do get the odd chest pain now and again when not excercising and if I get stressed but this is all a lot worse since I found out I would need a bypass.

[kenkeith]

QUOTE: "I have had a angiogram and have been told that I will need a Triple heart bypass as they cannot use stents because of the position of the narrowing and that one of the larger arteries is slightly blocked".

Slightly blocked vessel does not lend itself to a bypass nor a stent unless there is chest pain...the AAC and AHA have established guidelines stating not to stent nor bypass an occlusion less than 70%.   A position of a blockage is an issue that almost always requires a bypass if medication does not relieve the symptoms..  

My experience 6 years ago required a stent on a 98% blocked RCA (stented), circumflex 72% blocked not stented, and a 100% blocked LAD that has sufficient collateral vessel blood flow to the area that was supplied with the LAD.

My situation is similar to yours, in that I only exerience (angina, chest pain) with exercise.  Medication has prevented any progression of CAD (may have reversed) and I take a nitrate before working out...no problems with angina.  I have regular echocardiogram testing, etc. to monitor any negative developments.  My medication is an ACE inhibitor, beta blocker, statin, aspirin, multivitamens, and occasionally a nitrate.

There is no particular advantage of a stent implant and bypass over medication .  All three therapies treat only the symptoms, and it seems reasonable to go the least interventional option.  You may want to read the COURAGE study that has given a statistical evaluation of the 3 options.  Take care.

[wgang]

Just a word:
   I was told all of what you said.howver in my opinion and in my circumstances none
or the things you mention are never an issue for me.I had a quad bypass in 1997,and
my heart after strengthening it in 2007,was no problem for my Aorta Valve replacement
in 2008.The surgeons said my Quad was still in great working order and thats ten years.
They tell me my new valve may last five years,or thirty years with the right type of care
and lifestyle.I have no special diets,no promises that I will live forever.My Quad was no
big deal,and was decided within three hours,with the surgeon,My valve replacement was
decided in minutes.There were special talks,only direct speaking and decision.
   Do It!!!
   I have not been sorry.If I had stayed with two Cardiologist who were not exactly helping
me,and taking their time to keep me only on medicines,which were worse than the surg
ery.Needless to say,they are out of my life now,and were replaced with two reputable
surgeons whom were in agreement with me.
     I have  a Great Life,and the pains are not serious because I will not let them be ruin
ing my life.Its a mindset.
  Do whatever makes you feel good about yourself.
Wgang

[ed34]

All we can do here is give our personal opinions and give you food for thought. A bypass is obviously a big decision and not to be taken lightly. First of all, you state that veins last 10-15 years which is the usual blog spilled out of surgeons mouths. This is a very broad statement to make because the variety of longevity of veins is huge. There is no guarantee they will last 6 weeks, or 20 years but this is the kind of range I'm speaking of. Mine lasted 3 months. However, what you can do is speak to your surgeon and discuss your procedural details before they happen, make a plan with him. One thing I have learned from all my personal experience is that not enough people get involved enough with the Doctors and have input with the details. I sat in front of a computer screen looking at my angiogram with a Cardiologist last year and I was saying things like "what if, cant you, what about". He loved it, so did I and he said he much prefers it when a patient gets very involved, but unfortunately its just so rare.
Veins are not the strongest of vessels and they have a lot of stress changing their role to become coronary arteries. However, you have a spare artery in the left side of your chest and the right side which you can give up. These are the internal mammary arteries, known as Lima and Rima. The surgeon can check the flow in these vessels and if the flow is good (rare if not) then he can use these to graft onto your coronary arteries as a strong feed. These arteries will last the rest of your natural life and are strong enough to cope with feeding the heart. This means you will require just one vein but this can be used for the least important of the grafts. When my bypass failed after three months, the first thing they wanted to do was open me up and try another one but I refused. Ask your surgeon to use those arteries and if he cannot, find someone who can. This is a technique becoming much more common now and it will free you from being opened up again for a re-attempt. I would also ask the surgeon to ensure that he grafts those arteries well away from the blockages, giving plenty of room. My stupid surgeon used two veins and my Lima, BUT he grafted the Lima right onto the blockage which means it couldn't feed into my coronary artery. So I strongly suggest you get involved and make sure what happens is what's best for you long term.Nobody cares about your body as much as you do and when you speak to surgeons it's worth keeping that in mind.
As for when you have the procedure. My opinion is that it depends on your symptoms. If you are suffering discomfort then it's likely your heart tissue is struggling and the more it struggles, the longer it will take to recover. I have seen many patients who let their symptoms get worse before surgery and they have still not fully recovered, even many years later. My opinion is that the sooner you have the treatment the better. Due to so many people not recovering as much as they would like, even after full blood flow is restored, makes me believe there is still something not understood about heart tissue.
If I knew two years ago what I know now, I would have had my surgery sooner and been so much more involved. I would probably have chosen a different surgeon too. I would have put a big X on my angiogram showing him where I want the grafts done.
Whatever you decide, I really do wish you all the best but I'm sure you will be fine and have a long healthy life if you take my advice.