Worried about chest pain....

Hello all. I had a heart attack and mild stroke in June of 2003. I have had 8 cardiac catheterizations and a 64 slice Coronary Artery CT Scan since then. I have 4 stents. 2 Taxus ll and 2 Cypher. I have 3 stents that overlap in my LAD (end to end). Last March my local hospital wanted to do GABG due to a 95% blockage in my LAD.

Instead UAB did a procedure called rotational arthectomy and placed 2 stents end to end with one that was already there..

I have been out of the hospital for a little over a year, and I love that. That is a record for me since June of 2003! But, I am starting to have angina and grow tired really easily again.

My questions are; have any of you had angioplasty performed on restenosed stents that are overlapped, or have you ever heard of it? Do you think they will want to bypass this mess of plumbing if it is restenosed badly? What about the minimally invasive cardiac surgery for this area? I'm afraid of that saw....

I also have a stent in my left circumflex and a blockage upstream of it, that was at 30% last March. My RCA is congenitally small and irrepairable (can't get a cath wire in it). It supplies the bottom of my heart and may be the cause of my current angina.

I had a stress test done 3 months ago to get "cleared" for sinus surgery and this test showed the bottom of my heart was not receiving enough blood flow during exertion or at rest. I am not a fan of stress tests but this sounds logical.

As I proof my post, I sound like an elderly lady, but I am a 54 year old male, and of course there is nothing wrong with sounding like an elderly lady if you are one :)

Thanks very much in advance for reading my long post and for any information that you may have.

Goldie

[suzy61]

Are you talking about University of Alabama  hospital.  Just curious, as my Dr. is associated with UAB and I went there recently for a-fib.  susie

[Flycaster305]

I also have multiple stents, but they aren't overlapped, so I cannot comment on that.  However, I also have a congenital condition of a small, twisted RCA.  The docs tried to open up an 85% blockage in the RCA with a stent but couldn't get it through the artery, so it was opened to 50% with Angioplasty.  I was told a bypass procedure would be difficult because of the twisted, narrow artery. I'm told I'll probably have to have Angioplasty from time to time when I experience Angina. I hope you keep us posted what procedure, if any, is used to solve the problem.

[Al Dente]

i would get another opinion.  you have alot of metal in there already (i have 1 stent in my RCA and have had one heck of a time controlling angina).

restenosed stents, and procedures to go in and open them up place more have a higher complication and failure rate--i'm remember back to my grandmother who had about a years worth of success with 2 stents, needed 2 more which occluded in 2 months.  she ultimately had the bypass.

i think i'd look into bypass.  just my personal opinion, i'm weary of stents (my guess you have a barrel of Plavix).

good luck!  

[Flycaster305]

I also have a dominant left artery, I didn't know the ratio, only that I overheard the docs commenting on that the first time I got a stent.  I remember explaining to the docs that it was because I am left-handed.  It made sense at the time, having been fed goofball pills to relax me :)

I agree with you about Angina, it's a wonderful warning system.  I use exercise as both a conditioning activity and diagnostic tool, eg, when it's time to contact my Cardiologist.  I used to be terrified of angina pains and followed the usual male method of dealing with health issues --- ignoring them, which led to a heart attack and dead heart muscle at the base of my heart and CHF.  I'm taking Coreg, a miracle drug in my opinion, which has improved my heart function along with daily exercise.  This blockage that can't accept a stent really worries me, however, and I'm extremely interested in what takes place with your situation.  I'll monitor this site, in between fishing trips for Spring Chinook Salmon.

[Goldie54]

Thanks so much to all of you for your responses.
  
Yes Mam Suzy61, I am speaking of the University of Alabama hospital. Great hospital and staff they have there. Dr. Misra did my arthectomy. Stayed on the cath table for 1.75 hours.

Yes AL, I am weary of stents and I do have a barrel of Plavix, lol. I am more weary of CABG though. I had to give myself 15 shots of Lovenox in the belly after the deal at UAB....Makes me appreciate the Plavix, lol. I had to stop the Plavix for 6 days prior to the sinus surgery 3 months ago. It makes me wonder if the surgery was worth it. I have a sinus headache this morning...A stent could have restenosed during that time I guess. My cardio tried to get the ENT guy to wait 3 months for the surgery, but I had 2 tumors.

Thanks Al for the well wishes and same to you :)

Hello Flycaster, sorry to hear of your bad RCA. I know the feeling. The last time I was on the cath table the doc said looky here, I can't even get the cath wire into it. I have left dominant arteries, thank goodness. Less than 10% of the population does I hear.

I don't know what this round of angina involves. I really haven't had a terrible time with angina in the past, except when I had the heart attack and when I have had a blockage. I do know exactly what angina is and what it was meant for. A big warning signal that has never failed me. I have went too long with it, last Februrary, dreading the hospital and all, then you get angina and don't have the energy to walk across the floor. You suck on that nitro spray to stay alive. Boy that brings back bad memories.

I hope that RCA and the rest of your stents hold up. It's bot fishing time here. Course you may be a big time fall fisherman :)

I am really interested in the minimally invasive bypass surgery, pioneered by the Cleveland Clinic. For now it only works on arteries in the front of your heart, where mine are at, but I do not know what is blocked at the present. I will certainly keep you guys posted on what I find out, and if I can wiesel out of a CABG this time or not. I was hoping for angioplasty for a restenosed stent, or another stent for another blockage.

Best to all :)

Goldie

[Calamity Janie]

HI to all.
I am relatively new to the stent way of life.  I had a cardiologist who kept telling me my angina was esophogeal spasms until I had a heart attack in June 06. They put two taxus stents in the left main coronary artery and told me they should be good for 10 to 15 years.  One year and a week later they are both 50 % restenosed. I am a vegetarian who is careful with everything I eat.
I am 62 year old female.  My docs say they won't intervene until they are 70% blocked.
Do any of you get fleeting (goes away within 5 minutes) angina much of the day that is relieved by rest? I get symptomatic from climbing a few stairs or carrying a basket of laundry.  How do people with angina exercise??
I am taking Imdur, Cardizem, Plavix and one adult aspirin.  I have been asked if I am a victim of elder abuse from all the bruises I have all over me.I'm not, but my skin is thin and even brushing against something gets me a big hematoma.
I worry that since I am quite petite and thus my vascular structures are pretty small, CBS could be very difficult.
Have any of you heard about using gamma radiation and laser to open restenosed stents?
Good luck to all of you!  Calamity Janie

[often]

Hi Goldie,

Hopefully Jack54 will see your post and respond.  Your situation is identical to his.  He should have some insight, huh?