Is bypass surgery the only solution?

[Mala77]

My dad is 74 years old and has always been very active and fit. He leads a disciplined life and has been doing regular walking exercises and never has any hospitalisation or major problem. Recently, we had a Preventive Health check up for him and the TMT was positive and so an Angiography was performed. The results are as given below:

Left Main: Normal
Left Ant.Desc; Mid 100% Occlusion
Diagonal-1 : Proximal 80% stenosis and mid 80-90% Stenosis
Left Circumflex: Mid Plaquing
Obtuse Marginals-1: 75% Stenosis
PDA-LCx :Proximal 70% Stenosis
RCA: Ostial 50 % stenosis and proximal 50 % stenosis
Post Desc; Osteo-proximal 90% stenosis

Please advice as doctor has suggested either medication or By pass as stenting and Angioplasty is not possible for multiple blockages. Please advice as to how serious this condition is and what would be the best solution. My dad has no sympoms except for very very rare chest pain and that too on heavy exertion which again is not every time he exterts himself. I am worried about the flip side of surgery for someone who has always been so hale and hearty.Please help..It would be valuable to make a decision on his treatment.Is his case life threatening? please advice.

[CCFHeart MD25]

Your father has what is called 3 vessel coronary artery disease. The mortality benefit here is with bypass surgery. I would recommend a discussion with your cardiologist about this in addition to being on the appropriate medications (statins, beta blockers, aspirin).

[Mala77]

Thank you so much for your prompt reply. I do not have much details as this is the detail that was mentioned in the Discharge summary after the Angiography was performed and also the report has only the details I have mentioned.I do have the pictures of the Angiography. Not sure how I can send them. Will try and send the same by scanning it.
My dad is absolutely normal but after the angio, he has been prescribed some medicines...Ecospirin 75mg,Brilliant,concor 2.5 mg,Novastat 40 mg.
He is feeling some heaviness in the chest area and mild breathlessness  eversince medication started and now doctor has advised to stop brilliant and take deplatt A instead. I am really worried because I have never seen my dad become so weak all of a sudden.He has always been so active.
I lost my mother 60 days back and he is too much in stress. will send more details soon.Thanks

[ed34]

Your Cardiologist is right. There are a number of blockages but what makes it worse is they are spread out across multiple vessels. It would take many hours to treat those blockages along with lots of risk. What would be useful is a full report which will also tell the cardiologist what he is dealing with. For example, the left anterior descending is totally blocked halfway down, so it must be getting a blood supply from somewhere. He has likely experienced collateral vessels opening up, to feed this artery from another one. This is like a natural bypass. The report doesn't mention anything about retrograde filling though, so I feel personally it's a bit vague with the details. Let me put it another way. His Left anterior descending is totally blocked halfway down which means a large portion of his left ventricle is without a blood supply and he should be in serious trouble. This hasn't happened and I would want more detail to how his blood is transferred around the heart. Yes his arteries have blockages, but without the full picture I fail to see how any accurate decision can be made for intervention. Perhaps a further scan should be done, a nuclear perfusion scan, to give clues which areas are suffering low blood flow, if any.