I am 59 year old male with history of 3 MI's. The first at age 40.
I had CABG X3 in 1989 with great results.
I had CABG X5 in 2000 medeiocre results

I have been systematic since my last surgery but have been able to continue with most activities by pacing myself. In the last several months I have had significant increase in my level of discomfort and deterioration in my level of activity.

I have nine coronary arteries with 100% occulsion. I have 18 stents in these vessels that have all closed. All native vessels 100% blocked just off aorta. I have LVEDP > 30.

I am 7 years into my second surgery two graphs having been stented in the last year. After a recent cath, my cardiologist tells me I have several 90+% blockages in vessels to small for intervention. The doctors tells me that medication is my only treatment option.

Can anyone tell me if rotoblation or laser atherectomy be performed on the major vessels that are totally blocked or any other method of opening blocked vessels? I am anxious for more aggressive treatment than I am currently receiving.

PGable,

My first thought was is there any chance of getting on a transplant list?

Since the 1989 intervention, what kind of LDL's have you been running. I know this was before the introduction of statins. Have you since gotten on statin therapy? I would HOPE that you are controlling your LDL's to 60...that's what I;d do in your shoes.
Have you ever had your Lp(a) run?
Does your family share the ease of laying down plaque that you seem to suffer?

Absent the heart replacement, I think also that atherectomy might be your best bet. With the 100% blocked arteries there are two categories:
1. those that caused heart attacks, which by now are superfluous and won't benefit from a restored blood flow,
2. those that formed a collateral circulation BEFORE the blockage was complete.,,opening THOSE will give a vastly increased blood flow and an easing of symptoms.

I think it is important to find out WHICH blockage is causing you the greatest discomfort and perhaps attack that one. It isn;t likely that all your blockages are contributing to your deterioration, just one or two.

I too may eventually seek out an atherectomy artist if I need any further intervention, but I haven't gone so far as to try to find one yet. If you find a Picasso with a Catheter out there, please share.

I presume you are now on beta or calcium channel blockade?

You are relatively young, has a transplant been considered?