Unable to have bypass again

  If a patient is unable to withstand bypass surgery again(has already had two bypasses in six years and is in her 70's) because of such poor circulation that no good veins can be harvested and is not a candidate for anigioplasty what is the success of being treated with drugs only. Most of the left side of the heart is not working.The patient is not overweight and is not diabetice but is on medication for high blood presssure and cholesterol.  The patient otherwise feels fine after this last bought with chest pain. Is any research being conducted for aritificial veins and how is it progressing?  Thank you

[CCF Cardio MD - MTR]

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Dear Chris, thank you for your question.  If all possible conduits (veins or arteries) have been used for prior surgical bypass grafts, then a third bypass surgery may not be a viable option.  However, our cardiac surgeons are experienced with using the radial arteries in the wrists as bypass grafts, so that may be a potential option for the person you're asking about.  The key questions are whether another bypass surgery would relieve her symptoms of chest pain (and possibly shortness of breath) and prolong her survival.  There are no artificial veins that can be used for coronary bypass grafts because the vessels are too small which causes artificial grafts of the same size to be very likely to clot off.  Artificial grafts can be used to repair or bypass larger arteries like the aorta and the arteries in the pelvis since the blood flow is more brisk and the risk of clotting is much less in larger sized vessels.  If the person you're referring to has no other options and is incapacitated by chest pain, then there are other alternatives like experimental growth factors and laser revascularization procedures that are being studied in clinical trials.  For more information and for a possible evaluation here at CCF for bypass surgery, call the number below and ask for an appointment with Dr. Patrick Whitlow or Dr. Stephen Ellis.  
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.  Good luck!
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.