Stent or Bypass Surgery

Doctor - what is your take on CTO on Left Coronary Artery, 50% on Right Acute Marginal, 50% on Right Posterior Descending? Completed 11 minutes on Stress test but had elevation on 3rd minute which forced him to do angiogram with the results above. The patient is 52, non-diabetic but is not interested in CABG. His Cholesterol 174, Echocardiogram normal, A1C 5.9, healthy individual with 175 lbs, 5.11 height. He prefers, medications only treatment. What is your take?

I had open heart surgery 5 years ago and have 5 by-passes
Today, my holesterol is below 4 and I still smoke 5to7 cigarets daily
Last control I had in January
The doctor performed heart echo than stress test than heart echo again
I did not have chest pain during stress test
I was doing it 9 and half min
I am 65 and 94 kg ( lost almost 8 kg in last 7 months)
Eating healthy food taking medication every day ( for holesterol blood pressure heart and blood toner. My blood pressure is usually 125/80 heart rations vary from 65 to 80 depending on activity
The doctor said to me to come in 2 years for control
I would like to ask how long by-passes last?
Thank you and the best wishes

What should i do.

post MI (stemi) treted by injection
Diabetes

LMCA: normal
LAD: Type-Ill, good size vessel, has 80-85%stenosis at mid segment & 70-80% stenosis at distal segment D1 has 70-80% long segment stenosis at ostio-proximal to mid segment
LCX: Good size vessel, 80-90%stenosis at mid segment & OM2 has 75-85% stenosis at proximal segment
RCA: Dominant & good size vessel, has 30-40% stenosis at segment & PDA has 10-20%
stenosis at ostio-proximal segment & 40-50%stenosis at mid segment

Sir, Unhealthy diet and overweight are mother of all diseases. Yes?

Very good debriefing and thanks for providing such a good life saving procedures for consideration and selection. I have just had 4 Stents few months ago and now I am curious about why there are so many plaques in my coronary arteries? since my general health consideration is ok. Doctors kept questioning me whether I had any traditional herbs or supplements. A1c is between 5.4 to 5.7 but my triclyceride was 140, LDL was 140 and HDL was 45.

Thank you doctor

I am a male, my age is 68 years. My cholesterol and sugar are normal. I have 99 percent blockage in my left artery and 98 percent blockage in right artery. considering the possibility that there may be blokage in other arteries in future, should I undergo bypass surgery or get a stent installed? Please advise.

Hello Doctor,

My Father is 71 years old
Pre-diabetic patient! No gall Bladder!
No other major disease he has now in this age .
Diagnosis are:
——————————
LEFT ANTERIOR DESCENDING ARTERY: Mid Lad before bifurcation has discrete lesion with 60-70% followed by plaguing in the lower branch.
OBTUSE MARGINAL 2: obtuse marginal 2 is less than 2.5 diameter. Obtuse marginal 2 has significant disease major OM,Patiala playing followed by eccentric plaque with 70-80% stenosis
RIGHT CORONORY ARTERY: MID RCA has eccentric plaque with 50-60% stenosis, mid distal RCA had mutuple eccentric plaque with maximum 70% stenosis,

We got to know this situation when we went for regular health checkup, till now he had no major problem other than a bit of breathing issues.

What he is supposed to do ?

Can stent remove 100% blocked LAD and 90% blocked LCA? Can stenting be successful and what risk percentage is there?

A question please doctor answer to me. My husband has been found with a 50% blockage of a stent that was fitted in the left artery. They are suggesting a bypass but we find thisnoperation very invasive. Allmother arteries are fine, the muscle in the heart fine, evrrything else fine. Just this 50% blockage of the stent. They are not recommending stenting again. Why not? Please advice. Bless you.

Sir my mid lad 99 and RI is 99 what should i do .And i am dibetic

Ugh

LM: NORMAL

LAD, PROXIMAL 80% STENOSIS, FOLLOWED BY MIDSEGMENT CRITICAL SUBTOAL OCCLUSION WITH GOOD DISTAL FLOW

LCX: MIDSEGMENT 80% BIFURACTION LESION (1:1:0) MEDINA WITH GOOD DISTAL FLOW

RCA: MIDSEGMENT TIGHT LESION WITH GOOD DISTAL FLOW

Doctor

Please read the below and give me advise please

I am 74 years old, has ckd 3, diabetes type2, AIC 5.8. Can’t take aspirin as it irritates stomach. Has frequent chest pressure feelings, chemical stress test showed ischemia of R heart. Cardiologist said that this ischemia doesn’t affect heart function. Anglo of last year showed 70% narrowing of mid LAD. Dr is saying I am not a candidate for steering because I can’t take aspirin. I have pacemaker, on Eloquis. Does post CABG also require aspirin? What’s the next step for me?

Thanks to Dr. Bolad’s explanation, I now know what options are available and doctors may recommend. I have received 4 stents on my LAD, but my circumflex artery has some irregularities, which I don’t understand what it means. My first heart attack was on 1-27-2016. I am now on 10 mg of Rosuvastatin plus a 81 mg. Aspirin. My medication has changed from Atoravastatin 40 mg. for the first few years to 20 mg due to my muscle pain in my upper chair area which my cardiologist says in 2023 that my chest pain was due to muscular skeletal conditions after echo cardio gram with the stress test on a treadmill for a few minutes and then quickly lie down to check my valves operations. My cardiologist concludes that I might have over-exercised with weight lifting and muscle resisting at that time.) now with only 10 mg. of Rosuvastatin, I have felt much better while my bad cholesterol is in mid 70. I am not talking high blood pressure medication although I had been taking it for many years until last year when I started telling my doctor my chest pain. My A1C is now at 5.4 from 5.8 after I started doing intermittent fasting for 2 years. I got about 10 pounds and my fatty liver remains stable or unchanged. Dr.Bolad is a very careing cardiologist offering advice to people like me… I am forever grateful.

My fiance is 75 years old and his Dr at the veteran hospital suggest he have bypass surgery he already have 3 stents along with prostate cancer once someone has developed heart failure will they always have this condition?

I have 70-90% blockage in LAD, I’m diabetic hypertension mild overweight with symptoms of shortness of breath low energy. The cardio CAT test yesterday and the contrast made sick, vomiting in the CAT machine. They are scheduling a cardiac cath but have told me nothing but get to ER if I have chest pains. 67 years old w/family history of heart problems. Would I try to get the bypass to maybe get 15-20 more years or a stent that may fail in less time?

Sir i have 90% blockages in my mid and distal segments of my rca artery. Is one stent in mid segment enough?, As per my doctor's advice?

Hello Doctor , i m 34 year old , my angioplasty done 7 month before, my angiogram Lmca normal,Lcx Normal, rca normal, Lad ostial 100% thrombotic occlusion , D1 60-70% blockage.
My Lvef 60%, grade 1LVDD , my stent is Drug eluting stent , no diabetes, no hypertension, i m doing regular exercise, take ragular medicines. My question- is stent Life long? Can i live my full life after the angioplasty procedure?❤

Hi doctor. My dad just have open heart surgery 4 months.. He’s still suffered from blockage and doctor advice stent for next step.. Does it sound right please? Thank you!

Hello Doctor
My father is 71-72 years old. He just had palipitations at night for few years when we got his tests done his Lvef was reduced to 45-50 percent. After angiography the doctors found out RCA is blocked 90 perecnt with a lot of collaterals already present and LAD blocked 75 percent . The doctors went for stenting since my father was old and had diabetes too. The doctors couldn open RCA with stent because the block was too hard and LAD was stented successfully. The doctor told us he is fine now as the RCA has blood supply of collaterals and the rest 2 arteries are open.After the angioplasty he was sick for 7 days as his started having hypotension and then also got infection in the hospital. After 7 days he got completely fine and was discharged. He is on medications now. Can you tell us that what should be our future steps and what do you think of his treatment. what all tests are recommended for follow ups? medicines you would want to recommend?

Doctor thank you for your very informative video . I have got three blocked arteries ranging 50. 70 and 90 percent blocked. However I'm asymptomic . I run mist days ten Kms , am not overweight , gave up smoking 10 years ago and follow a diet . I have absolutely no symptoms currently and for last several years on medication . I am a border line diabetic and take matamorfim but sugar under control for last few years . I have been reccomneded a bypass but am not sure or comfortable due to my asymptomic nature and no pain or angina . Medication seems to be working . I'm 59 years , 173 cm and 70 kgs and generally follow a sugar free diet and minimis meat consumption. Appreciate your advice on whether the bypass will add value currently or I could continue on medication and lifestyle .regards jhon

Dear Dr. Bolad - I have 3-vessel coronary disease and a recent stress exercise echocardiogram shows I have left ventricular dysfunction. I will get an angiogram soon. Will the interventional cardiologist make a decision on his own during the procedure whether to use stents, or is he expected to consult with my cardiologist before doing so? Will the interventionalist tell me his findings while he is performing the angiogram? If he wants to use stents will I be asked to give my consent, even though I will be sedated during thr procedure? Thank you.

My father is 75 and needed by pass but refused and he has diabetes so he had 4 stents put in what is life expectancy compared to bypass?

Thank you. Very informative. Especially choices for the patient.

Thanks a lot, good decision. I have no diabetes. I need how many stents for me. I went to stents your hospital. how to contact you. sent your hospital location. md israful alam from Bangladesh.

My name is Israful Alam , My age is 42 year, My CAG report Date 11/09/2023 National Heart Foundation and Research Institute, Bangladesh, capital city in Dhaka. My CAG report , LMCA: Free of disease , LAD: type Iv vessel and 80-85% stenosis in its proximal segment followed by 99% stenosis in its mid segment and 40-45% stenosis in its distal segment. LCX free of disease. OM has got 80-85% stenosis in its proximal segment . RCA: Dominant vessel and 80-85% stenosis in its proximal segment followed by 99% stenosis in its mid segment and 50-60% stenosis in its distal segment. LIMA Free of disease . Now I need Stent or Bypass Surgery.

Hello Doctor,

My mother aged 66 had a chest pain last week and the doctors did Angiogram. She told the pain was not that much intense and it was more like a burning sensation and gastric trouble.The doctors said there are 3 blocks,discharged after 4 days and asked to come back for CABG. Now she is using the prescribed medicines and is stable now. Please share your opinion.
How to share the reports to you?
Thanks

Sir my mother is 65yrs old, have rheumatoid arthritis. Now having chest pain sometimes. Doctor said she have blockage in coronary artery. Which will be good for her stent or bypass?

Sir, my father is 61yrs old, diabetic, suffering from CAD with 80% blockage in LAD and 25% in RCA. Which will be better stenting or MICS bypass?

Why is diabetes such a big factor? Is age ever taken into consideration?

I'm 71years old, my Aorta valve is to narrow and next month I'll be taking to cardiac surgery. I prefer open heart surgery but i have had mitral valve surgery 2× already, so I know what to expect. I live alone and no one can help me once home. I'm also diabetic on metformin. The doctor will be checking if I have and blocked arteries before my surgery.

Do you have a section of minimally invasive coronary bypass surgery? I think that would be a good option for those who may have blood clotting and bleeding issues. Thanks.

Hello doctor, thank you very much for the great work you are doing,

My doubt is, If we are having good 2d echo and ECG then can we be sure that our Heart health is good ?

Because I would like to do these for my parents 1/2 times in a year to have a check on Heart health.

If there are any other tests which we can do once in 6 months to check our heart health then please let us know

Thank you

Can stenting be used in patients with TVD and DM?

I had bypass more than 10 years ago

The doctor tried doin pci but he couldn’t reach to my arthritis because of the location not sure why but I have 3 of them blocked 100% .. when I asked about doin bypass he told me my arteries are too small can you tell me what to do because I have angina and it’s hard to live like that

Hello Sir
My father 45 years old went to bypass surgery 2 years ago
Procedure was leg veins was used
Is this procedure is good?
Please help me sir!
Is veins procedure from legs is long lasting

My mother put two stent in her heart. Chest pain for several days now.A another block comes where the doctor is thinking ..By pass surgery is good for her now?? Or again put another stent in her heart..need your suggestion please..

Hello Dr, 13 years ago my father had done a CABG procedure. Since then he is been going through gastrointestinal problems such as indigestion, constipation and many times he needs to take a medications to eject the waste. Would it be a side effect of any blood thinner tablets that was taken during these years? We were advised to see gastroenterologist at many occasions but it doesn't help much. Is it normal to be like that?

What is the role of collaterals if pt doesn't want to go for either of procedures otherwise asymptomatic

For the bypass surgery of my wife, internal mammery vein was used about 6 months ago. But till today there is no sensation on her left breast. Will it come to normalcy? please advice. Thanks.

Thank you so for the information Dr Bolad, I smoke, some things in the morning I don't feel better, when sleeping at night , I sleep very well but once I wake up I don't feel good and I don't know if its ulcer or heart disease that am having, pls help me out. Each time I feel as if my blood pressure is high when I woke up in the morning. Thank sir and God bless

Thanks for the information ❤️