Avatar universal

Saphenous Graft Life-cycle

I am 54 yo white male. 15 years post-op CABG X 4. Three months ago had 3rd acute MI (STEMI, inferolateral). Complicated PTCA with 2 overlapping bare metal stents to clear acute proximal thrombotic occlusion to RCA. Feasibility of stenting questioned by interventionist at outset (I was in cath lab for 2.5 hours...somehow he pulled it off).

Angiogram showed several other stenoses of varying dimensions. Obviously pursuing aggressive risk factor mitigation.

My primary concern is deterioration of saphenous grafts. At 15 years post-CABG I have to believe morbidity/mortality data is pretty dismal.

Is stenting the only remaining option in this circumstance, or would arterial grafting be possible solution as vein grafts progressively worsen?

Any insight would be welcome.
1 Responses
Sort by: Helpful Oldest Newest
976897 tn?1379167602
I believe that angioplasty has come a long way in the last 15 years and what was considered ridiculously risky back then has become more acceptable. However, there are obviously still some restrictions such as location and size of the occlusion.
With regards to your vein grafts, I was told in 2007 by a surgeon that they are expected to last over 20 years now. Mine lasted three months but nobody can tell me why.
You are correct in that you can have your mammary ateries used, the Lima/Rima. Being arteries these do last longer than veins, mine is still open while the veins have decided to go to sleep. With regards to stenosis, it depends on the restriction being caused. If you 30 occlusions of 40% then you should be fine (in theory). Only 70% and above is considered a real problem. So, although you may have several other stenoses it may not be as dire as it sounds.
Helpful - 0
Have an Answer?

You are reading content posted in the Heart Disease Community

Top Heart Disease Answerers
159619 tn?1707018272
Salt Lake City, UT
11548417 tn?1506080564
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
Is a low-fat diet really that heart healthy after all? James D. Nicolantonio, PharmD, urges us to reconsider decades-long dietary guidelines.
Can depression and anxiety cause heart disease? Get the facts in this Missouri Medicine report.
Fish oil, folic acid, vitamin C. Find out if these supplements are heart-healthy or overhyped.
Learn what happens before, during and after a heart attack occurs.
What are the pros and cons of taking fish oil for heart health? Find out in this article from Missouri Medicine.
How to lower your heart attack risk.