My friends father recently suffered a heart attack and was advised to undergo angiography. The test showed 100% blockage in two of his arteries and was recommended open heart surgery. He is 61 years old and has suffered from hypertension and high blood pressure for the past 3 years. He has lived with the fear of doctors and surgeries all his life and is now strongly refusing to undergo the surgery. No amount of convincing from the doctor or the family seems to help. I recently read about cardiac rehabilitation. I understand it is a prevention program to improve heart conditions but was wondering if it would work for someone with 100% blockage? There seems to be very little chance that the patient might change his mind about the surgery. In such a case, can cardiac rehabilitation work as an alternative? If not what are the options available?
There are only three major arteries supplying the heart. With two of them blocked and only one patent, the only reasonable therapeutic approach is open heart surgery for bypass installation. Bypasses supply the parts of the vessel that lie "behind" the stenosis / occlusion with blood, so the blockage gets bypassed.
HOWEVER: One very important consideration is whether the parts of the heart that are supplied by the occluded vessels consist of viable tissue at all (or just plain fibrotic tissue); because, if it was just fibrotic tissue even perfect bypasses would not help; To determine that, your father needs to undergo a nuclear scan (FDG-PET) or cardiac MRI.
If there is viable tissue that just lacks blood supply, bypass surgery would improve his life expectancy tremendously.
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