Massive Heart Attack with 99% blockage
This is with reference to my father, with whom this problem has come into light.
I would like to narrate the whole case to you and wait for your response on the same.
Pateint age : 73yrs/Male
Patient was admitted in the hospital on 9th April 2010 due to a massive heart attack. After an Angiogram was conducted the report suggested bypass surgery because his heart was running on 1% blood supply.
1. The Angiogram report was out and a bypass surgery was suggested, I gave my consent on that at the very moment. While conducting the tests prior to bypass an ultra sound test showed carotid blockage & then to clarify this point CT Angio was conducted. The result was the same. (Long chocked block in the artery blocking 80 % of the blood flow)
2. Dr. Rajendra Kumar Jain (MD Cardiologist, KIMS, Hyderabad) listed 3 options as follows:
A. Carotid Surgery (5% risk of complete Paralysis + CABG (10% risk of complete paralysis). Both the surgery's in a period of 2-3 days.
B. Carotid Angio Plasty (3% risk of complete paralysis + CABG (5% risk of complete paralysis)
C. PTCA on the artery which is 99% blocked as told by the Cardio team of the hospital.
D. Carotid problem can be taken after sometime as the brain is silent & not alarming right now.
In that sitting I chose C & D option but on the next day Dr. Jain was reluctant to perform even PTCA and stated, while doing PTCA we have to stop the blood for atleast 30-60 seconds & other two arteries are 100% blocked so that PTCA cannot be performed as the risk in this method is also high & suggested me to take a 2nd opinion from other Cardiologists.
3. I approached Dr. Sunil Kapoor (Chief Cardiothoracic Surgeon, Care Hospital, Hyderabad) with CAG CD report & CT Angio documents after which he suggested that CABG & PTCA cannot be conducted as the carotid artery has a long choke blockage & thus could lead the patient into complete paralysis. He stopped us from any surgery on this patient.
Dr. Sunil Kapoor added, on doing a risk-benefit analysis between the operation and medications, the former has more risks involved than the latter & could lead the patient to either death on the operation bed or a complete paralytic attack whereas with medications & good dietary care, he can live a good quality life. He also mentioned that the blockage in the arteries of the heart is not more than 80% [According to KIMS it was 99% blocked].
4. Dr. Bhaskar Rao (Chief Cardiothoracic Surgeon, KIMS, Hyderabad) & Dr. Rajendra Kumar Jain (MD, Cardiologist, KIMS, Hyderabad) also agreed to the suggestion put down by Dr. Sunil Kapoor saying, the patient can be kept on medications on my request.
Actually after 2 months my elder son's marriage is fixed and its an event of my family but on the other hand my father's health is my foremost concern.
I want to know further, If the bypass is inevitable can I keep him on medications for 2 months.
Please let me know your valuable suggestions as soon as possible so that I can take the final step and go ahead with it.
Looking forward for a genuine and positive reply.
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Last edited by hb-mod; 04-19-2010 at 09:22 AM.
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