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Interventional Cardiology (Expert Forum)
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Truman Medical Center
MO
Questions in the Interventional Cardiology forum are answered by medical professionals affiliated with the Truman Medical Center. Topics covered include acute coronary syndrome, angina , atrial fibrillation , cardiac catheterization , cardiomyopathy , drug abuse & cardiac disease, echocardiography , heart failure , hypertension & heart disease , lipid management , minorities and heart disease, peripheral vascular disease prevention, valvular heart disease , women’s heart health, and the warning signs of a heart attack.
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by ritao, Oct 08, 2007 09:43PM
I have an extensive cardiovascular history for someone who is 59. To be totally honest, I do not understand most of it. I would love to have some "straight" answers. I don't know how much of my history you need to know.
March 2007 had a drug stent placed in LAD (was told he placed a stent inside a stent) April bypass in the left subclavian artery and left vertebral artery. Past history CABG 3 vessels 2000, LIMA to LAD, SVG to circ and SVG to ramus intermedius (occluded) I saw my doctor this week, due to angina. He said when he did the heart cath in March, there was a 60-70% blockage that may be restricting blood flow to LIMA bypass, but at the time he did not/could not deal with it beacuse of the subclavian blockage. When I asked how this could be fixed, he said to let him worry about that. He has me scheduled for a nuclear stress test, (which I always fail) then probably a heart cath. But I want the facts, no sugar coated .. what are my options??
Thanks for any and all info..
March 2007 had a drug stent placed in LAD (was told he placed a stent inside a stent) April bypass in the left subclavian artery and left vertebral artery. Past history CABG 3 vessels 2000, LIMA to LAD, SVG to circ and SVG to ramus intermedius (occluded) I saw my doctor this week, due to angina. He said when he did the heart cath in March, there was a 60-70% blockage that may be restricting blood flow to LIMA bypass, but at the time he did not/could not deal with it beacuse of the subclavian blockage. When I asked how this could be fixed, he said to let him worry about that. He has me scheduled for a nuclear stress test, (which I always fail) then probably a heart cath. But I want the facts, no sugar coated .. what are my options??
Thanks for any and all info..
Doctor's Answer
by Douglas Bogart, MD, Oct 09, 2007 04:35PM
, Oct 09, 2007 04:35PMTo: ritao
The LIMA comes of the subclavian artery and if the subclavian is blocked you could have a lack of blood flow to the left anterior descending artery which was grafted by the LIMA. I don't know the type of surgery you had on the subclavian but sometimes the subclavian can be stented. Ask your doctor about this.
The surg I had on the left subclavian artery.. they used an artifical artery it could not be stented.
I still do not understand. This is additional to the surg for left subclavian artery... is that correct?
History.. 1: Three-vessel native coronary artery disease 2: Normal LV function with EF 60% 3: Chronically occluded SVG-ramus bypass graft. 4: patent bypass graft to the OM 5: Peripheral vascular disease with a 60-70% proximal left subclavian artery stenosis with 40 mmhg gradient across this lesion. 6: 50% ostial left vertebral arter stenosis
7: successful PTCA with adjunctive drug-eluting stent placement of the native proximal LAD reducing a 95% in-stent restenosis down to a 0% residual stenosis with a 3.0/13 mm Cypher drug-eluting stent at 20ATM
This is the report from my last heart cart in April 2007