help for below coronary angiography report

[MoNaeiji]

Dear Doctors

the below is my 66 years old father coronary angiography report, I need help and advise for what procedure we have to take

Under Local Anesthesia
Approach: Femoral
Dominant System: left
E. F: 45%
L.V Wall motion: Global hypokinesia
LV: 140/0-18
Aorta: 140/80
Left Main Stem: Normal
LAD: proximal has multiple stenosis up to 70%, at bifurcation with the diagonal is near cut off with delay run off and multiple stenosis at mid portion and also good distal run off
Septal: Ostial of the septal has stenosis up to 90%, a large vessel
Diagonal: Ostial has stenosis up to 80% , a large vessel
LCX: Ostial has a mild stenosis with good run off, a large vessel
OMs: Ostial has stenosis up to 60%, small vessel
RCA: Has Multiple stenosis from the origin up to the mid about 95% with no good distal run off

please check and help
thanks a lot indeed

[ed34]

the arteries and veins and usually harvested through arms and legs, not involving the chest. The chest is opened for grafting those vessels onto the heart? However, if I understand what you are trying to ask, "can they do bypass without opening the chest". It depends on what surgeons are trained in. Most surgeons are trained to open the chest but there are a handful who can operate through holes inbetween the ribs. If something goes wrong, then the chest is immediately opened. Such questions should be asked of the surgeon to establish his expertise.

[MoNaeiji]

thank you very much for your answer
from other side my father has rectum cancer, he is having a colostomy bag till now,
do you think endoscopic vein harvesting and endoscopic radial artery harvesting can be done instead of Traditionally, that chest is opened in the operating room ?

Kind Regards
Mozes

[ed34]

If symptoms are present. then I would have to suggest bypass surgery as there really is no other option.