risk of MI and death if not undergoing CABG

[worried0000]

In a67year old asian male with diabetes who has 70% ejection fraction on ECHO but aseverely calcified 90% ostial stenosis of LAD, 70% stenosis of RCA and 60% stenosis of circumflex who is on aspirin, clopidogrel, nitrate, nicorandil, ramipril ,OHAs statin,atenolol ,currently asymptomatic, what is the risk of death/MI if CABG declined

[Jack54]

Tex it's "more gentle".

If one has a 90% blockage at the BEGINNING of his LAD, he is less than 10%, blockage wise, away  from a massive heart attack. Do you know how fast a blockage can go from 90% to 100%? Real damn quick. No one may know when and if the big one will come, but Las Vegas oddsmakers with backgrounds in cardiology would give 100:1 within 1 year.

[Texheart]

I will be more gentler than Jack....No one knows when the big one will come or if we will get a big one. Where are you located?  U.S?  If you are in the U.S. can you consult with the Cleveland Clinic in Ohio?  They are TOPS in the country.  If you are in Asia, do you have a good heart center there?  

I too have the same as you.  Ejection fraction is also 70% with severe coronary artery disease in two arteries.  I see my doctor regularly and am on much of the same meds as you.,  Yes, I may end up having by=pass surgery but do not know at this time, when.  I try to manage my heart disease by living healthy and taking my medication and exercising.  I wish you well.  HD sucks.

[Jack54]

I had the same problem, except my blockage was 95% at the VERY ostial LAD. My cardiologist wanted to do surgery, because it is extremely hard to stent, as you know. I asked if UAB could stent this blockage. They conferenced and the University of Alabama at Birmingham hospital, UAB, said they could stent this lesion.

I was transported 100 miles to UAB where Dr. Vijay Misrah performed a Rotoblational Arthectomy of the blockage, and inserted 2 stents. Part of this stenotic lesion extended into my left main.

I would have been dead very soon I was told. The procedure was much more complicated than I had expected, as I found out only after it was over. They had inserted a temporary pacemaker into the right side of my heart, through a right heart cath, while working through a left heart cath simultaneously.

This was 20 months ago. I have since had the most ostial stent of my LAD to restenose and was restented at the Cleveland Clinic, in May of this year. I now have all of the stents that I can have in my LAD (4 end to end). I am just waiting on CABG. The Cleveland Clinic refused to perform minimally invasive bypass surgery on my LAD, because I still smoke a bit. This was not the official story, but I heard this from 2 nurses. Police will fine you for smoking around that hospital. They are anti-smoking Nazis.

If you cannot find anyone to stent the LAD, I would definitely have the CABG. I hate to tell you what you already know, but you need to remember that you are not far away from a massive heart attack.

Best of health and wisdom to you,

Jack