Left Main Coronary Artery

Wife (age 48) had CABG x 4  a few yrs ago. Shes diabetic and takes insulin for 38 yrs. Was a smoker, 15 lbs overweight, former hi BP, has high cholesterol. She had bypassed her LAD (they used IMA).  Vein grafts from her leg to other arteries.   Recent angiogram shows a 50% proximal blockage to her LAD native artery and a 40% blockage to her Left Main. When they do a bypass, is the Left Main (LMCA also bypassed with the LIMA (at time of surgery LMCA had 0% blockage)? Also if your native arteries start totally blocking does that affect the grafts? Thanks. I'm not getting any answers from the Drs and would rather know than not know.

[Douglas Bogart, MD]

If the patient has blockage in the left main artery they bypass around it to the left anterior descending and left circumflex.
It is very common to have blockage in the native arteries--it frequently progresses after bypass surgery.  As long as it is not downstream blockage(blockage below the insertion of the grafts) it is no problem to the grafts.  The grafts can close because of downstream blockage or blockage in the grafts themselves.