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Urology (Expert Forum)
Praying for wisdom regarding renal artery surgery
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Praying for wisdom regarding renal artery surgery
by Dener, Sep 15, 2003 12:00AM
I am 59 year old female with a health history of high blood pressure for many years. I had heart attack 4 years ago with 5 stents (yes, five!) placed in my right coronary artery. That artery is completely closed now. I have recently been diagnosed with renal artery stenosis in both of my renal arteries, one artery they say is 80% blocked and the other 90%. They tried the stenting procedure but it did not work, so kidney artery bypass surgery is recommended.
Now they tell me there are also problems with my aorta artery due to so much build of plaque from the heart disease. That if the surgery is done, it will be high risk for me, since they will probably need to replace part of the aorta artery also.
After much prayer, I just cannot feel a peace about having the surgery at all. The risks seem to outweigh the benefits for me. Can you tell me what to expect if I do not have the surgery? I understand that in time, I would go into kidney failure. Would I have time to be put on dialysis. I know no one can say for sure about all of this, but I just wanted to get an idea. My dear family, of course, wants me to have the surgery and do everything I can to extend life. I feel the opposite, that the surgery is very dangerous for me.
Maybe it is fear, or perhaps it is wisdom and warning, but I am waiting on God to lead me to the right decision. Thank you so much.
Now they tell me there are also problems with my aorta artery due to so much build of plaque from the heart disease. That if the surgery is done, it will be high risk for me, since they will probably need to replace part of the aorta artery also.
After much prayer, I just cannot feel a peace about having the surgery at all. The risks seem to outweigh the benefits for me. Can you tell me what to expect if I do not have the surgery? I understand that in time, I would go into kidney failure. Would I have time to be put on dialysis. I know no one can say for sure about all of this, but I just wanted to get an idea. My dear family, of course, wants me to have the surgery and do everything I can to extend life. I feel the opposite, that the surgery is very dangerous for me.
Maybe it is fear, or perhaps it is wisdom and warning, but I am waiting on God to lead me to the right decision. Thank you so much.
Doctor's Answer
by Kevin Pho, MD, Sep 19, 2003 12:00AM
, Sep 19, 2003 12:00AM
Surgical revascularization leads to a fall in systemic BP or infrequently cure of the hypertension in 70 to 90 percent of patients with atherosclerotic disease.
The mortality rate for renovascular surgery in most reports is between 3 and 6 percent, with patients with diffuse atherosclerosis and congestive heart failure being at greatest risk.
Consequences of not having the surgery would include gradual loss of renal function and continued hypertension which would in itself lead to complications.
Regarding dialysis, this is a consideration that should be explored in conjunction with having the surgery or not.
As for the risks, this should be discussed with your personal physician. The mortality rate of the procedure is between 3 to 6 percent - the risks and benefits should definitely be discussed before agreeing to any procedure.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
The mortality rate for renovascular surgery in most reports is between 3 and 6 percent, with patients with diffuse atherosclerosis and congestive heart failure being at greatest risk.
Consequences of not having the surgery would include gradual loss of renal function and continued hypertension which would in itself lead to complications.
Regarding dialysis, this is a consideration that should be explored in conjunction with having the surgery or not.
As for the risks, this should be discussed with your personal physician. The mortality rate of the procedure is between 3 to 6 percent - the risks and benefits should definitely be discussed before agreeing to any procedure.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
