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My husband had quadruple bypass one year ago. Recent pain prompted another heart cath, which showed one of graphs had collapsed (SVG) that connected at branch of OM. Also, long blockage in LCA AD had increased from 50% last year to 60% this time. Left ventricle pressure is 139. Ejection fraction is 45%. It was 65% and pressure was 115 last year during heart cath that resulted in need for quad bypass surgery. Other graphs that are still in place are the radial going around a 90% blockage in RCA (that blockage now at 100%); a Lima graph connecting at lower part of AD; and another SVG along the PD. What are some of next step options? He is 53 years old
Mon, 28 Oct 2013
Respected Ma'm
Thanks for writing to us.
1. The blockade of SVG graft to OM can not be tackled by angioplasty if it was a chronic occlusion. Other grafts seems to be working fine.
2. Native vessels do develop higher stenosis over a period of time if the grafts bypassing them are working fine. it is physiological.
3. His EF has gone down.
4. Such a patient needs good, guideline based therapy including stating, beta-blockers, ACE inhibitors and anti-platelets. For pain, nitrates are given on SOS basis. You can discuss this out with your cardiologist.
Sincerely
Sukhvinder
Thanks for writing to us.
1. The blockade of SVG graft to OM can not be tackled by angioplasty if it was a chronic occlusion. Other grafts seems to be working fine.
2. Native vessels do develop higher stenosis over a period of time if the grafts bypassing them are working fine. it is physiological.
3. His EF has gone down.
4. Such a patient needs good, guideline based therapy including stating, beta-blockers, ACE inhibitors and anti-platelets. For pain, nitrates are given on SOS basis. You can discuss this out with your cardiologist.
Sincerely
Sukhvinder
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