Angioplasty vs bypass

[Balloony]

I've seen this before, but not specific to my case.  I have to have a valve replaced and am having an angiogram to see if there is blockage to be treated at the same time.  The physician doing the angiogram has indicated he will put in a stent if he finds blockage.  My feeling is that this is unnecessary as the major advantage of angioplasty (less invasive than bypass) is totally irrelevant since I'm having a valve replaced anyway.

Thoughts?

[Balloony]

Thank you all for your most insightfull responses.  To follow up and close out - my throacic surgeon followed up with the doctors doing the angiogram and made it clear that he only wanted the angiogram done.  (I might mention that my thoracic surgeon is one of the top in the world.)  And, as the angiogram turned out, I have absolutely no blockage at all - zip, nil, none.  (This to the absolute disgust of my wife who nags at me incessantly for putting so much butter on pancakes or 1/2 and 1/2 on my cereal.)  Other than the valve issue, my heart is apparently in great condition.

Again, thank you all.

[ed34]

risky procedure? An angiogram is less risk than driving a car. I signed a consent form
on thursday for rotablation/stenting which states 1%. You can't get any lower than that
with anything in life, even laying in bed all day.

[kenkeith]

30% have some CAD doesn't seem reasonable to base a risky procedure with that probability.  Many people have some CAD, but don't require a stent implant!  In fact if the occlusion is not greater than 70% and no symptoms, it is advised not to stent.

[ed34]

you will need to be on blood thinners for your operation, you should in fact be injected with quite a strong one. The reason is that you don't want any clots forming in the area
of surgery that can break free and block a vessel in the brain or other major organ. This
will not stop the healing.
If I was in your shoes I would have the angioplasty if required. You don't want to have this
valve procedure to find you suffer a heart attack next week. It's like asking a mechanic
not to check all your engine at the same time. You want the whole engine checked over and necessary adjustments made. There's only a 1% risk associated with angioplasty
and so there's no real concern.

[Balloony]

Thank you for your response.

According to my thoracic surgeon, approximately 30% of people my age have some coronary atrterial blockage.  He has said, since he's going in anyway for the valve, we might as well check on the arteries and, if there is any blockage, handle it at the same time .  It's the physician doing the angiogram that has indicated he wants to put in a stent.  I'm not really hot on the idea of being on blood thinners when I go in for valve replacement.  

[mammo]

Is he thinking you may have blockage not involved with the valve?  I would question him as to why he is doing this.