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Blocked arteries, please give your thoughts

Hi my father recently had an angiogram and the results are below,
LMS - unobstructed
LAD - Sub-total occlusion in proximal vessel
Cx - large dominant vessel, atheromatous but not flow limiting disease
RCA - Sub0total proximal occlusion, with further distal occlusion, PDA filled with collaterals from left

Please would some explain what this means, the doctor have said to go for a bypass or angioploasty, my father has no symptoms, not chest pain and walks quite a lot with no breathlessness or pain. can he rely on collaterals. he's on various tablets at the moment.

Please would someone shed some light.

Thank you in advance
1 Responses
976897 tn?1379167602
Hi. You have to think of the heart as two pumps in one. You have the left side and the right side, both having different jobs. The left side pumps freshly oxygenated blood around the living tissue in the body, the right side pumps used blood back to the lungs to obtain fresh oxygen. So everytime you see L preceding an artery name it refers to the Left side, while R is the right side. The PDA is at the back in the middle. The LMS or left main stem is the artery on the left which comes directly from the aorta (largest artery in the body) and is the main feed for all the arteries which feed the left side of the heart. This is a clear vessel according to the results which is great. This vessel then branches into two, the first being called the LAD (left anterior descending). This goes down the front/left side of the heart. In the report this is nearly totally blocked at the very top. The second branch is the LCx which runs down the left/rear of the heart. According to the report this vessel is diseased (atheromatous) but not enough to be concerned about. The RCA (right coronary artery) comes straight off the Aorta and runs down the right side of the heart. This vessel according to the report is nearly blocked at the top and is totally blocked near the bottom. The PDA is usually filled by the RCA (unless co-dominant) and your Father has opened collateral vessels (natural bypasses) from the left side to feed it.
You have 2 options, but due to the amount of work, I think stenting (angioplasty) is the best solution. This requires very little recovery and nearly zero chance of infection. They would pass a catheter through his arteries to the heart and use a balloon to expand and open the blockages. The balloon has a tiny metal scaffolding on it (stent) which is left in place to hold the vessel open when the balloon is deflated. The stent remains there and new tissue grows through it. I hope this helps and if you have any more questions please dont hesitate to ask.
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