80% blokage in D1, what to do now?

[GuilhermeMartins]

Hi, i had a mild hearth atack 3,5 years ago, they put me 2 stents, the result of catheterism was: "right coronary: dominant whith multiple lesions, the biggest is 100% in 1/3 distal (stent); posterior ventricular of the RC: big importance, whithmultiple lesion, the biggest is 80% in 1/ medium (stent); main Left coronart: no lesion: LAD: passing the apex, , multiple lesions, the biggest is 30% in 1/3 midlle;D1: moderate importance, localized lesion onf 50% in 1/3 proximal; Circunfelx: reach the 1/3 distal of AV sulc, whirh multiple lesion, the biggest is 60% in 1/3 midlle. I am ok from now , no pain , feel really good!
  Now, my cardiologist request a Coronary Angiotomography, the result is: " Calcium Score:not avaiable, due to presence of stents, high risk of obstrutive actual lesion, high risk (more than 20%) of future coronary events). Coronary anatomy: right dominance coronary circulation; main left bifurcated , whitout lesions; LAD whit calcified and mist plaques throught the vassel, discrete luminal reduction in proximal (30%) and moderate luminal redution (50%)  in midlle.Has big diagonal branch, ostial severe lesion of 80%- calcified plaque.;Circunflex dominant whith 60% of luminal reduction in 1/3 middle.Has marginal branch whirh difuse arteriosclerosis of 30%.. Conclusion:Triarteial coronary pattern, impossible to avaliate reestenosis of stensts due the little calibre of it.
So, from what i am thinking, my D1 is very worst, i am concerned, next days i will go to my doctor to show it, if possible answer me to that:
1: can it gave(80% D1 stenosis) me another hearth atack?
2:  is it possible to put a stent, even in a ostial position ? it can afect teh LAD?
I feel ok, no pain in chest , nothing, do exercises,alimanetation is not very good, i must change it for sure! I take 100mg aspirin, sinvastatin, potassic losartane and atenolol since my infartion. Thanks in advance for yours answers and God bless you all!

[GuilhermeMartins]

Can someone  give me a second opinon, please? Thanks in advance

[ayl291]

I wish I could help more.  But I think advising surgically here is very difficult.

Are you in the US?

[GuilhermeMartins]

Hi ayl291, i live in Brazil, here we have o good Heart Hospital (Messejana, were they did my angioplasty).
You say "very dificult" why? location of lesion? i read that ostial lesions are somethimes inoperable due the danger of problems caused to main artery (LAD in case). Or other reason? the main reason i am concerned is the possiblity of other heart atack if that branch ocludes ! by the other way, i think...correct me if i am wrong...that artery is not a main artery, deadly, it will be a medium (if it is possible to happen!) atack! or there is a life danger in that case also?
Sorry for my doubts, i am worried, tryng to find the best way to deal whith. Next days i will go to cardiologist,  if necessary i will go to that Heart Hospital  to show them that Coronarian Angiotomography. Best regards

[ayl291]

The LAD is one of your 2 main branches... it essentially perfuses the anterior LV.  I think a second opinion is definitely in order!