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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Unstable Angina, Angiography And Plasty Done, Performed Two Stenting. What Could Be The Reason?

hello.my father 58 yrs old have unstable angina till last 1mnth.n now at 8th april angiography n plasty done after stress eco.
again 2nd plasty done on 10th.the procedure performed is ptca+stenting to-lad (xience v 3.0*28mm).....n ptca+stenting to -lad(xience v 2.75*12mm).now he is at home.lastnight 14 he have fever after evening walk.now he is oky.sir pls tell me why doctors performed 2nd stenting on 10th april.why not during 1st surgery at 8th.1st surger is done by junior doctor n 2nd by his senior doctor.1st they told that there is no blockage there. then how can 2nd blockage occure.is it doctors mistake.within 2days 2 surgeris okay for patient.ecg n colordoppler at 9th april showshypokinetic lv apex,apical ant. septum,apical inf. wall lvef 50%. there is concentric lvh. there is diastolic dysfunction grade 2.no mr. cad,rwma.
Fri, 19 Apr 2013
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Cardiologist 's  Response
Soemtimes, when there are several blockages in the coronary arteries, particularly in an acute setting such as a heart attack (infarction) or unstable angina, the initial priority is to treat the "culprit vessel" (lesion that is likely leading to the acute presentation). If there are other significant lesions that don't look acute, then a "staged" procedure can be done, meaning that the other blockage or blockages can be addressed at a later date. That might have been the case. The ejection fraction is mildly depressed from normal (55-75%), but with the medications he has been prescribed and the procedure it will be reassessed later on looking for improvement, which might happen or not. Hope it helps.

Dr Brenes-Salazar
Mayo Clinic Rochester
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Have Unstable Angina, Angiography And Plasty Done, Performed Two Stenting. What Could Be The Reason?

Soemtimes, when there are several blockages in the coronary arteries, particularly in an acute setting such as a heart attack (infarction) or unstable angina, the initial priority is to treat the culprit vessel (lesion that is likely leading to the acute presentation). If there are other significant lesions that don t look acute, then a staged procedure can be done, meaning that the other blockage or blockages can be addressed at a later date. That might have been the case. The ejection fraction is mildly depressed from normal (55-75%), but with the medications he has been prescribed and the procedure it will be reassessed later on looking for improvement, which might happen or not. Hope it helps. Dr Brenes-Salazar Mayo Clinic Rochester