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Old 07-19-2006, 11:35 AM   #1
keith.uk
Junior Member
(male)
 
Join Date: Jul 2006
Location: Leeds uk
Posts: 29
2 vessels arteries decrease

I'm 46 been to hospital today had angiogram got this 2 vessels arteries decrease
1 big one 95% narrow
1 small one starting to narrow

they have give me 2 choices coronary angioplasty or coronary bypass surgery

at the moment dont no which to pick they going to send for me in 3 months by then i have to pick 1
======================================== ================
Is it safe to have coronary artery bypass surgery?
Coronary artery bypass surgery is still an effective way of relieving angina, stabilises the heart and improves the quality of life for patients. A recent study showed that there were no significant differences in the quality of life between people who had beating heart surgery and those who had surgery using the bypass machine. However, the patients included were considered to be at low risk of developing complications and they were only followed up for one year after surgery. Further research is needed in this area.
If you are worried about having problems with your cognitive function after bypass surgery, your cardiac surgeon for an individual risk assessment.


Medical Information Department, December 2005
======================================== ==========
I think its going to be this because of the relieving angina but my family are not happy about it they say i should go for coronary angioplasty i think they are worried about the risks .
coronary angioplasty fewer than 5 in every 1,000 people die
coronary bypass surgery 20 in every 1,000 people die
the reason i want this is bacause of relieving angina pains .
i dont think i'm been selfish. just thinking of the pains from angina i dont want
======================================== ====================
medication i'm taking at moment
bisoprolol 10mg tab
Diltiazem hydrochloride 60mg 3 times a day
aspirin 75mg tab
lansoprazole 30mg cap
simvastatin 40mg tab
clopidogrel 75mg
Isosorbide mononitrate 40mg twice a day
glyceryl trinitrate (deponit) patches 10mg or spray

Last edited by keith.uk; 07-16-2007 at 07:38 PM. Reason: medication up date
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Old 07-19-2006, 03:02 PM   #2
Fathersson
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Re: 2 vessels arteries decrease

well, I am not a doctor, nor do I know you and the details of your situation, so take this for what it's worth.

I have had one highly successful cardiac angioplasty and stent implacement, and I have had one highly unsuccessful one. The latter turned into a situation of uncontrolled bleeding, tamponade (blood, and hence pressure, accumulating around the heart), which in turn led to my being rushed out of the cath lab and into surgery for an emergency CABG. Admittedly, this was while trying angioplasty to place stents in a CTO (chronic total occlusion - an old, heavily calcified, total blockage), and CTOs are often referred to in medical journals as the last great unconquered frontier in PTCA (in other words, higher risk then PTCA/stenting of an acute or a partial blockage).

Angioplasty and stents can be as successful a procedure to releive angina as CABG - I really don't think the issue is whether one or the other is more or less able to relieve your symptoms.

Both are subject to similar long term risks - failure of the reopened (or bypassed) blood passage by continuing progressive CAD. So aggressive measures (diet, activity and lifestyle as well as medications) to control, stop, or even reverse the progress of CAD is a must.

The risks of the actual procedure are quite different though, and the CABG looses out on that score (mainly, to my mind, due to the increased risk of infection - a concern in these days of ever less effective antibiotics). Also, recovery from CABG is a much longer and a much more unpleasant experience than recovery from angioplasty (especially when it is a scheduled, prepared-for procedure - my first one was while in the midst of a heart attack).

However, the decision is affected by so many variables unique to each persons specific health issues and such, that it's impossible to make any great generalizations.

If it were me, and the blockages were good candidates for stenting, I'd choose that over surgery. A stented artery can always be bypassed in the future if problems continue or arise anew. While a bypass can also be stented, should it fail in the future, the choice for a first course of action still would be clearly on PTCA and stents in my mind.

Good luck with whatever you decide. Just remember that neither procedure is a cure, just a treatment. So be sure to talk with the docs about diet, lifestyle, exercise, followup medications - everything you need to be doing to make the stents or bypass remain effective for a good long life-time.

P.S. I'd also want a consult with the surgeon who would actually do the CABG. Ask him whether he plans on using a vein (usually the saphenous vein from one of your calves), or an artery (usually the internal mammary artery). Long term useful life span (patency) of mammary artery grafts appears to be much better/longer then vein grafts. Also ask him whether he would be using a heart lung machine, or one of the minimally invasive techniques which do not require the heart to be stopped - the two approaches have their own pros and cons, so have him go over them with you. Have a consult with the interventional cardiologist who would be doing the PTCA as well, if you can. Ask him things like, does he have a straight approach to the sites of blockage (blockage in the curve of an artery, or at the jusction of two arteries is much more problematic), how long does he estimate the procedure (the radioactive dye used can cause liver toxicity problems if exposed to too much of it, or for too long).

Last edited by Fathersson; 07-19-2006 at 03:13 PM.
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Old 07-19-2006, 05:17 PM   #3
keith.uk
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Join Date: Jul 2006
Location: Leeds uk
Posts: 29
Re: 2 vessels arteries decrease

Thanks for the reply's... 95% of 1 of the big arteries is narrow
and a smaller 1 was starting to narrow hope this make sense its just all big shock to me all this And I do appreciate the advice thanks it helps when someone has the same problems or similar
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Old 07-20-2006, 10:48 AM   #4
Lenin
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Re: 2 vessels arteries decrease

Keith,

By ALL means have the angioplasty-stent...that is my recommendation in a hearbeat. It has ALL the advantages and and after all, even if it fails the other much more invasive option is probably still open to you.
For me it would be a "non-choice."

Gee, now we have a Kenkeith, a Ken and a Keith.UK...if you are Penelope Keith, I'm in love with you .

Last edited by Lenin; 07-20-2006 at 10:49 AM.
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Old 07-20-2006, 05:25 PM   #5
keith.uk
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Join Date: Jul 2006
Location: Leeds uk
Posts: 29
Re: 2 vessels arteries decrease

thanks all going for first choice angioplasty talked it over with my family thanks everyone
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