choices choices choices

I had a high troponin level in 2007 which showed my Heart was suffering badly from a lack of oxygen and emergency
stenting was performed to my Circumflex (obtuse marginal 1). The Angio images showed my LAD was totally occluded after the main stem and it was assumed my Heart would be severely damaged. My RCA showed several
nasty near full occlusions and so a nuclear perfusion scan was performed. This revealed no damage and to everyones
amazement I had grown new tiny vessels across to the narrowed LAD, giving just enough of a feed to keep the tissue
alive when I was at rest or light exertion. A decision was made by my Cardiologist that the best solution would be to
rotablate the occlusion in the LAD and allow the vessel to fully open. Other Doctors disagreed and I was put on the
table for a CABGx3. My Lima artery was grafted to the LAD along with a Vein from my leg. Another Vein from my
leg was also grafted as some form of diagonal. I felt better after surgery and recovered amazingly fast. I did notice
some odd things like dizziness during rehabilitation but no angina. Exactly three months after surgery I was on my
knees gasping for air and angina returned with a vengeance. Angiogram images revealed my worst fears, the veins
had closed up completely. The Lima is still a good vessel but the surgeon had grafted it directly onto the main
occlusion in the LAD, rendering it useless anyway. He performed a kind of endarterectomy to the graft area which
created a 'trough' in the occlusion but it was still blocked in both directions. My LAD is seriously narrow but a recent
perfusion scan shows oxygen is reaching all tissue and surprisingly well. Cardiologists state that the perfusion scan
shows my heart is very healthy and if it wasn't for the angiogram they would assume there was nothing wrong.
I have been to three different hospitals to try and find a Cardiologist who can come up with a solution and try to
resolve the problem. One hospital offered a redo-Cabg which I turned down. They then offered a transplant which
I couldn't believe because there must be a way to open this occlusion. Finally, after 2 years, a pioneer has appeared
who is willing to clean out the occlusion using rotablation. The occlusion is on a curve and quite long which puts all
other experts off, but this individual feels he can do the job by going through the Lima.  I apologise for the long
build up and now I can finally ask my questions.
Using rotablation, I'm certain there will be a large amount of debris. Is this controllable during the procedure to
prevent the risk of a Heart attack or stroke? I know the rotablator obliterates plaque into tiny pieces but there is
a huge mass sitting there.
Why would my Coronary Arteries be the only vessels affected by this disease? I have been told cholesterol was
the cause along with smoking and a genetic history. I was diagnosed with hypercholesterolemia. I have had scans
of many blood vessels in my body and no other disease has been found. What particular chemicals in cigarettes
homes in to the Coronary Arteries and causes atherosclerosis? These are just arteries like any other and I simply
cannot work out how cigarettes are intelligent enough to attack just three arteries out of over 60,000 miles of blood
vessels in the body. If cholesterol is the problem then why would the average person in Switzerland have higher
cholesterol than me yet be much less likely to develop the disease. There doesn't seem to be solid evidence that
high cholesterol means atherosclerosis will form. I'm sorry if I come across a bit sore but I have heard so many
contradictions from different doctors over the last two years and in the end you don't know what to believe.
Many thanks
Ed

[mammo]

Maybe I can help a little.  Rotoblation can cause a piece of plaque to break away and enter the bloodstream.  My husband suffers from Peripheral Artery Disease, and Atherosclerosis, resulting from smoking until 20 years ago. But heredity, and lifestyle also play a major role in this.  My husband suffered an aortic aneurisym (from smoking) tongue and throat cancer.  A once avid runner, can now barely walk to his car due to leg pain from blockages. When you stop smoking your lungs immediately start repairing themselves, but the damage done to your cardio vascular system is forever.  Once diagnosed with these conditions you do have plaque building up in every artery, just not to the point of causing a blockage at the time.  My husband develops one blockage after another in different areas of his body.  High cholesterol doesn't guarantee atherosclerosis if you take medication and make lifestyle changes.  If left untreated and one continues to eat all the wrong food, the arteries will clog.  I think you should consider yourself fortunate that your have no other build up at this point. Because you are at risk for having more, your whole system is affected, not just the few areas you mention, just not to any significant amount. It amazes me that with every specialist we see, their first question is "do or have your ever smoked?"  Scandinavians fare better than Americans because their diet is high in fish, and not red meat.  Oil from the fish has a lubricating affect on the arteries, allowing plaque to not stick to the artery walls.