Saturday, April 25, 2009

Solution for the Two Grafts block among the three grafts in post CABG Case under went surgery 10 years back? -

Female 58 yrs of age , Hypertension , diabetic. known case of IHD , Triple Vessel Block underwent bypass surgery (CABG) 10 years back (1995) , unstable angina amp; breathlessness . Coronary Angiogram done in 2001 revealed that one graft was blocked (LAD) and she was on medication and recently she was admitted for unstable angina and breathlessness and coronary angiogram was done a two months back , the result was two grafts (LAD * RCA) was blocked and only one (OM) was patent , Doctor has recommended for medication . I just wanted to know whether alternative solutions (.i.e. repeat bypass surgery etc). please suggest

There must be reason he doesn t want to do a redo surgery. Is she not a good candidate or inoperable? If you don t think so, get a 2nd opinion. Redo surgeries are more tricky than the first especially when you have the problems she has( diabetes, HTN). She doesn t sound like a great candidate. Is she noncompliant? I work in the ICU with open heart surgeries and redos are generally so much more difficult and the patients are usually more sick and critical. Thats not saying it can t be done, but will it truly make her life BETTER than it is right now being so high risk? She is at a very high risk for infection, bleeding ( b/c of all the scar tissue) heart failure and failure to thrive. I know she is very symptomatic now, but with redos hospitalizion is usually prolonged and sometimes the turn out is worse than before the surgery. Find out with the doctor why he doesn t want to operate and discuss with your family whats best for her. Good luck to you guys.

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