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Heart Problems

i suffered severe heart attack 2 months ago and now doctors suggest. me bypass surgery.my main artery is working 30% and rest arteries are in gud condition.and i got natural bypass which is gud sign told me doctors butt still they suggest me surgery.is there any solution by medicines and changing lifestyle?
2 Responses
20748650 tn?1521032211
Think i answered before... Hut if you were recommended for bypass then its too late for medicine anf lifestyle.. These things will slow or prevent the situation from getting worse, but it wont fix the damage thats already done.

Dont knoe,why you were recommended for bypass with 1 partially occluded region, typically a single area gets stented if the other arteries are clear. Sounds like theres another complicating factor they didnt communicate well enough...
Avatar universal
I didn't get exactly that there is no way in medicine science without bypass surgery as now i m living more hectic life befr heart. attack doing walk n exercises and no hard feelings then what are the measurement for such major surgery.how i can feel that now the bypass surgery is needed.A doctor asked me that if u r living normal life den no nees of surgery bcz surgery is also for ur normal life.
what can i do for myself??
1 Comments
Well yes, in that regard the doctor is absolutely correct. Some patients choose to hold off on surgery if their symptoms are not severely limiting for them.

In these cases patients risk losing some degree of their remainjng myocardial viability, or the chabce that a portion of the muscle will heal if they ever decide to get treatment.

They are also at increased risk of a myocardial infarction (sudden heart attack) compromising their collateral circulation (natural bypass) later in life.

Make no mistake these patients dont get better without the surgery. They can however make lifestyle modifications, such as pursuing a healthier diet, and they can take medicines such as statins (lipitor), beta blockers (atenolol in particular), dual anti platelets (aspirin and plavix), and a anticoaguant (such as heparin or lovenox).

These combinations of drugs are designed to help lower the risk of that sudden heart attack and to slow the progression of the disease (it slows down how fast new blockages form)

The existing chronic occlusion.. The block that you have however remains, and any damage thats done can not heal with this alone.

That said, for patients that reject the treatment they often feel that they can tolerate any discomfort caused by this damage, and would rather enjoy life, spend time with their families etc then risk open heart surgery in an attempt to add a few more years to their life expectency.

Quality over quantity is the focus there, no different then a cancer patient that prefers not to risk an operation or chemotherapy.

As for your question regarding surgical candidate selection theres 3 primary types of patients that are refferred for surgery instead of catheterization/stenting.

1. Patients with 3 vessel disease (most common).

These are patients whos disease effects not just 1 single artery but rather all arteries in their heart. For these patients they run into a problem.. Every stent we place into the body significantly and exponentially increases the probability of a phenomenon called in stent restenosis, a heart attack caused by stent placement. At some point it actually becomes more risky to place additional stents then to perform a surgery.

2. Complex lesions, in this case the blockage is simply located in a spot where its difficult to seat a stent properly, often this occurs at a bifurcation, or a spot where an artery splits into seperate branches.

Techniques such as the 'kissing balloon' often allow us to mold the stent into the proper shape, however these techniques are technically challenging and require the placement of wires and balloons in very specific places. In some patients complicating factors such as vessel tortuosity (twisty vessels due to chronic hypertension) make the placement of the hardware in the proper place difficult. In this case its better to pursue a surgery then to place a stent incorrectly.

3. Excessive stenting- for patients that already have received nunerous stents or excessive stent layers surgery is sometimes the best alternative.. See rationale #1
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