alternatives to heart surgery

A recent heart catherization revealed several blockages but I am not experiencing any symptoms (no angina, no chest pains).  Are there any alternatives to open heart surgery?  PS I have been told that stents and angioplasty are out of the question.


This discussion is related to Open Heart Surgery Alternatives.

[TonyC2639]

I assume you mean the doctors told you that stents were out of the question.  If that's true, you don't have a lot of options.  I don't know how prominent the hospital in your area is for cardiac care.  You might consider going somewhere else for a second opinion.

[NTB]

As a general answer: you could try a medical approach, which would mean large doses of potent statins - and combine that with profound lifestyle changes.

That means you undertake the risk of statin side effects, which might or might not be considerable.

Statins plus diet might lead to regression in your blockages - they'd get smaller. At the least you might prevent them from getting larger.

Evidence is mounting that most heart attacks are caused when a plaque ruptures, and that inflammation is a key player in rupture.

[madjlp]

Odd that stents are out of the question - do you have a pre existing condition that complicates your treatment?  Allergy to anesthesia?  You didn't mention the severity of the blockages or your age - is it possible that the Drs don't want to treat because the % blockages are not diagnostically significant or "normal" for your age?  If you don't have answers to these questions then I'd second TonyC's suggestion to look into second opinion.   good luck

[NTB]

isn't a common reason that the location of a stenosis can preclude a stent? E.g., placing a stent there might block of another artery that branches off at that point. Or maybe the stenosis is at a really bendy part of an artery.

Another possibility: when calcification goes all the way around in a circle, then a stent can't push the blockage off to the side.

Any corrections or comments on any of that are welcome.

[kenkeith]

Turbulence, like hypertension, may physically injure endothelial cells. Evidence
supporting this is the fact that plaques tend to form in areas of high turbulence in vessels,  Where the circumflex and LAD branch from the main artery is an area that creates heavy turbulance that may create lesions.  It would be very difficult to stent a "Y" configuration...stenting one branch compromises the other branch's opening.  Also, a tortuous vessel may preclude stenting, etc.

AAC/AHA guidelines are not to stent any lesions less than 70%.  With occlusions greater than 70% treat medically.  If chest pain is not relieved with medication, then open heart surgery may be only option.

Sometimes one can have damaging ischemia without angina (chest pain) such as when the indiviudual has diabetes...that would be the risk with just medication.  Medication can dilate vessels sufficienctly (probably a size of stent) enough to prevent heart cell damage...it works for me for the past 5 years, requires monitoring every 6 months and I take a nitrate prior to a workout (3 times week) at the Health Center.