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[ritao]

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..

[Douglas Bogart, MD]

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.

[ritao]

This is what it said in the report.. LIMA-LAD  Patent bypass graft(with subselective injection of the LIMA with a left subclavian angiogram there is noted to be significant restriction in the blood flow into the LIMA bypass graft due to the LIMA graft origination distal to a 60-70% proximal left subclavian artery stenosis.  
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