Is Surgery for me Obvious?

[Cornfed]

Greetings.  An angiography revealed a blockage of about 60-70% where the LM meets the LAD (I think that's correct....it's in a really bad spot).

Interventional Cardiologist says he'd worry about long term safety of putting one or more Drug Eluting Stents in there to address since he'd worry about a clot forming down the road.

So, he says I need CABG.

Does this sound right to you all?  The only symptom I have is jaw pain, and it only comes with high exertion (no jaw pain when walking or on elliptical machine.  Only get it when running).  So, it is stable angina at this point.

Just want to make sure I'm doing the right thing.  I'm on meds for cholesterol, etc.  Just wanted to make sure this was all correct and that I'm doing the right thing.  I'm in my mid-thirties.

[allmymarbles]

(1) Coated stents have serious problems. Uncoated stents are safer. (2) Go for chelation. My husband had two aborted heart attacks 15 years ago. One of his arteries was 95 per cent occluded. He underwent IV chelation therapy. After chelation his blood pressure fell to 120/70. No sign of arteriosclerosis. After about 10 years his blood pressure started to rise. He should have gone back for chelation at that time. He did not. Last month he was rushed to the hospital with an evolving heart attack. The inerted two stents (uncoated). He is now undergoing chelation again.

[kenkeith]

QUOTE: "Greetings.  An angiography revealed a blockage of about 60-70% where the LM meets the LAD (I think that's correct....it's in a really bad spot)"

>>>Yes, that is a bad spot and it often presents a problem.  That is the area where the left decending artery (LAD) branches as does the circumflex.  The bifurcation  is a difficult area to stent as a stent in the LAD may compress the lumen of the circumflex and cause some occlusion.  There may be a "Y" shaped stent!?

If medication opens the artery and you can tolerate the meds, that is the best way to go at the present time.  I have been told by my doctor medication can sometimes reverse CAD, there  is some confirmation on the internet, but I remain unconvinced...but in a few years there could be effective treatment, who knows, you are young.

I have a totally blocked LAD and 72% circumflex, and i have been on medication for the past 5 years without any problem.   I have exercise regimen 3 days a week and take a nitrate med prior, and I have no problems.

[Cornfed]

Thanks.  I appreciate it.

With regards to quality of life, my symptom - assuming it's cardiac-related - is really nothing.  The reason I even question it's cardiac related is that apparently jaw pain without chest pain (I have NO chest pain) is apparently very rare (1%?).

That said, I do believe I have a real problem due to the angiogram result.  Also, due to it's location, I think if I have a heart attack, I'm dead.

I think my cardiologist is very aggressive and wants this addressed.  I did setup a second opinion for next week with a different practice.  I think they both refer patients to the same hospital for surgery if needed, but at least it's a different interventional cardiologist practice.

I do assume he'll say surgery, too.  Surgery doesn't make me happy (I fear death, stroke, etc, but also the cognitive decline effect.  I work in a technical field and am slowly pursuing a very technical scientific PhD which I fear I will no longer be sharp enough to complete).

But it's certainly better than being dead, so I'm going to do what the docs say.

Thank you again for your help.  I really appreciate it!

[ed34]

You can always get a second opinion, but make sure it's from a different hospital. Maybe
organise it through your GP. Many Cardiologists have different opinions and it will probably turn out that the second opinion will repeat what you have already been told.
You are in your mid thirties with many years ahead of you, but you have to weigh up
what quality of life you want. If you can have benefits from a bypass, then you
should strongly consider this. Of course, you always have the option of having no
procedure performed, it's your body and you have the last say. It depends on what
you want from life. It is likely your problem will worsen and you will require a bypass
at some stage and nobody can say how long this will take. Many people live with
stable angina for years and years.