Unilateral ankle edema 2+ years post CABG

[Yvette BG]

I have a question about my Mom, who is 82 and had triple bypass in Dec. 2007. Her right ankle, the side they did the graft, remained swollen (to varying degrees) for about 9 months after the surgery. (She did have brain surgery at the end of Jan. 2008 and also emergency brain surgery June 2008, and the doctors said that impacted her recovery from the heart surgery.) Anyway, her ankle had gone down to normal size for at least a year. Recently, she's developed congestive heart failure again and her ankle is now swollen as well. (She refuses to wear ted hose or other compression stockings.) She agreed to having an echocardiogram, EKG, and chest X-ray to figure out why she's having breathlessness near the end of sentences and shortness of breath with walking, but nothing more diagnostically, no invasive tests and no further surgery.

My question is--Do you think her swollen ankle is from CHF or do you think there's a possibility the bypass is failing?
Or is it possible she's developing lymphedema?  

Thanks for your perspectives.

---Yvette

[kenkeith]

CHF will cause peripheral and lung edema (fluid within the tissue).  The cause is the inability for the heart to pump effectively and fluids back up into the lungs and peripherals.  An echo can help determine the size of the left ventricle and any location of heart wall impairment caused by a prior heart attack.

Sometimes lying down with legs elevated can reduce the swollen ankles.  I was admitted to ICU just based on shortness of breath, it is very telling for congested heart failure.  I felt well and was shocked 6 years ago to hear I had had a heart attack and CHF.  Currently, my heart has returned to normal size and the heart is pumping normally.  

The bypass may be failing and/or there are other occlusions and that may take a CT angiogram  to determine.