Should we do angioplasty or we should go for By-pass surgery?

[Nilesh0904]

My Father is 60 yrs,  started complaining of Chest pain a month back & we got ECG, Angiogram done.
Angio results are below:
- Left Main:- Long shows ostial non-obstructive plaque.

- LAD : Type III vessel shows tubular 80% lesion after D1 & non-obstructive plaque in mid & distal part, D1 small to moderate shows proximal non-obstructive plaque, LAD give collaterals to PLV

- Ramus : fair size normal vessel.

-CIRC : Non-dominant moderate size vessel. Shows tubular non-obstructive plauqe at the level of OM1. Distal LCx gives collaterals to PLV. OM1 is to moderate with ostial non-obstructive plaque.

-RCA : Dominant vessel with early bifunction into moderate sized normal PDA. PLV is moderate ub size shows 90% tubular lesion iin its proximal part. Mid & distal PLV is moderate sized & opacified with TIMI- II flow. Distal PLV receives collaterals from left

-LV angio : LVEF 50% on 2d echo.
LIMA normal

doctor who have done the angiography have sugessted multivessel PCI. But we contacted another doctore after seeing the reports he said go for by-pass surgery, we are totally confused.
What we should do should we do angioplasty or we should go for By-pass surgery.

[ed34]

As you can see, just as the professionals do, we have different opinions also. Those opinions with us are based on experience. My bypass lasted three months, I've met people who have seen their bypass fail after just weeks. Some people are lucky to last years but nobody knows how long it will last. If stents do start to re-block then bypass is still an open option.
Another thing to keep in mind is that bypass does nothing with existing blockages. The blockage material stays as it is. This means, over the years it will worsen and if a bypass fails in a few years, then stenting may be an impossible option to fall back on.

[Flycaster305]

I think I'd defer to the medical professional who knows your father the best.  What kind of physical shape is he in?  Does he smoke?  How likely is he to change negative cardiac behaviors that have led to his condition?  Is he likely to agree to take medications that will help his condition?  
The word 'Ostial' refers to cholesterol obstructions where branch arteries take off, and that is always a very dangerous area to place stents.  I'm guessing this is the area of question expressed by health professionals, and a disagreement.  Keep in mind, I'm not a health professional.

I was 60 years old when I got a similiar diagnosis as your father.  In my case, I wish I'd accepted bypass at that time.  I'm good with changing behaviors, taking good medications, exercising, etc.  That said, it's a tough question to answer, none of us really know.  I'd ask the second doctor for a good explanation of his 'ostial' blockages and if that is why he is recommending bypass surgery.  
Whatever route your Dad chooses, do keep us informed, and best wishes!

[Smiley2000]

Yes, I agree with "ED" to get the minimal-invasive procedure at least a go and the if the Cardio/Surgeon still feels that they need to do a Bypass, then you know that he has tried all his options.

All the best,

[ed34]

There is no guarantee with either procedure as to how long they will last. Personally, I would go for the much less invasive procedure to start with.
So I would go for angioplasty.