still having pain after bypass

[sally]

We have a friend who has had angioplasty, then shortly after, bypass. She remains troubled with SOB and chest pain that is relieved with Nitro. About 1 month after bypass, a small artery (not a major one) was re-clogged and could not be opened because the MDs said the artery was too small to go into. She remains in pain with occas. SOB. Her MD suggested a fairly new procedure where, by cath., they do laser to the heart making many holes and allowing for more arteries to form and hopefully taking away the pain.
What is this procedure called and how effective/safe is it? Her MD told her the chest pain is not life-threatening but it is intolerable to her and scary. They even said that little "heart attacks" at this point would be "good" because the artery would scar. Is this a very common procedure now? Any advice would be much appreciated.

[Cleveland Clinic, MD]

The procedure is called PTMR or TMR.   PTMR (Percutaneous transmyocardial revascularization) is an experimental procedure using laser to treat coronary artery disease.  It is only used when the disease is not amenable to conventional methods of treatment.  The concept is based on the alligator heart which has no coronary arteries but only small channels from the inside of the heart to the heart wall.  Basically a laser is used to "drill" a tiny channel through the wall of the heart allowing blood to flow to ischemic areas.  

The laser can be  introduced during open heart surgery or through a tiny tube inserted through the leg.  If  you or someone you know is interested in participating in an ongoing study of PTMR here at the Cleveland Clinic please call the number below and ask for Marsha Lowery at extension 40052.

[Lori Jakiela]

My mother has had multiple bypass surgeries, as well as angioplasty and stents.  She now has blockage to the left coronary artery, and her old bypass grafts have closed.  Her doctors have sent her home on medication, and she suffers from ongoing bouts of angina.  The doctors have chosen not to put a stent in the artery, which is now the main source of blood flow to her heart (there is significant blockage in all other areas).  What else can be done for her?  What are our options beyond maintenance medications?

[Eric]

HAD BY PASS SURGERY IN MARCH 1999, TRIPLE.  10 MONTHS LATER AM STILL HAVING CONSIDERABLE DISCOMFORT IN CHEST AT NIGHT.  ALSO, BOTH ARMS GO NUMB AT NIGHT, AND I HAVE CONSIDERABLE SWELLING IN MY HANDS, IT BECOMES HARD TO MAKE A FIST AND I CANNOT MOVE MY WEDDING BAND.  I WONDER IF THIS IS NORMAL AND WHAT MIGHT BE CAUSING IT AND WHAT MIGHT BE DONE?

[John V.]

My recovery after a triple bypass surgery last April was progressing at the expected rate until very recently when I started to feel a sudden pinching type of pain in my chest always connected with some movement of my arms. This is not an angina-type pain, and my cardiologist after a stress test assured me that there is adaquate blood flow to the heart.
The pain lasts only a split second but sometimes it takes my breath away as it comes very unexpectedly. Most of the time the pain comes in the upper right side of the chest, but other times it hits me in the center or the left. Has anyone else experienced this beside me? What is the cause? What is the remedy?

[George]

Had heart bypass (5) 10 months ago.  Heart is fine, so say doctors, but chest tissue aches - wouldn't say it was a pain.  Use to feel it mostly when clothing rubbed but now is there most often.  Feels like a weight is pressing on chest.  Others similar?  Suggestions?

[awaldro]

The TMR procedure is no longer considered "Experimental".  Audubon Hosipitol in Louisville Ky. Has done 125 tmr's where as Duke has come closest at 25. Dr allen Lansing pioneered this procedure. There are very specific requirements.  The patient must fit the profile. However, let me end by saying many people who have had a few open heart surgeries have had the tmr procedure and no longer had problems with chest pain. Remember, there are risks associated with surgical procedures such as this.

[Jim Aghan]

I recently underwent 3x bypass on the 17\04\00. I was progressing nicely until a month ago when I began to experience angina like symtoms again. I have been hospitalised twice since for (unstable angina?). Can  anyone tell me if they have had or know of someone who has had the same experience.

[Jim Aghan]

I recently underwent 3x bypass on the 17\04\00. I was progressing nicely until a month ago when I began to experience angina like symtoms again. I have been hospitalised twice since for (unstable angina?). Can  anyone tell me if they have had or know of someone who has had the same experience.

[Pat888]

A related discussion, chest pain was started.