please help if you can

i am emailing regarding my father, who has been diagnosed with Ischemic Heart Disease.  He is due to have CABG (quadruple bypass) and an ICD fitted in the next few weeks.  He suffers from Angina and has had several attacks of Ventricular Tacchacardia.  Following a scan of his heart, he was told that he had scar tissue in the Left Ventricle, and that this part of the heart is not working properly (this is resulting from a heart attack he suffered in 1990).

He is due to have the "off-pump" version of the Operation - my research suggests that he may well be better off having it done the more traditional CCAB way (recovery of circulation is apparently not so good with the off pump technique?) - do you agree?

My other question is whether you think my father could benefit from endoventricular circular patch plasty (EVCPP), otherwise known as the Dor procedure?  I discovered information regarding this procedure, and it seems that the scar tissue in his left Ventricle may benefit form this.  I would like my father to have it if could help him - i am looking for an independant opinion - please answer if you can.

Thanks in advance

Paul

[Michael J. McWilliams, M.D.]

Paul,
Those are very good questions, but would require significant review of the data.  Procedures like that are done usually at very specialized centers like the Cleveland Clinic or Mayo Clinic.

I do not typically make decisions about on versus off pump CABG -- the surgeons make that desicion.  If you aren't sure, it might be best to get a second opinion of someone that can review the actual studies.

The Dor procedure is still controversial.  I have seen a few patients with large aneursyms that may have benefitted from the procedure.  If he needs a procedure like, a high volume center is the best place to have it done.

I hope this helps.