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Question
Posted by: Cincerned Wife | 2012-03-26

Stent vs Bypass

Good day Dr,

My husband is 32 years old, a non-smoking diabetic, slighty overweight recently underwent an angiogram which revealed 3 blocked arteries (one is 100% blocked, the other tow are 50-60% blocked). The Dr partially opened the 100% blocked artery &  there is some but minimal blood flow. One artery is at the branch of the main atery &  inserting a stent may compromise blood flow in the main artery. The third artery is extremely narrow, Dr said it may be impossible to insert a stent.

I am confused as his ECG was normal, his blood sugar levels was well controlled. His LDL was however 2.2. He has been on MIchol for more than 1.5 years and Cozaar for high blood pressure and glucophage for the diabetes. What went wrong?

The Dr said if the stents are too difficult he will have to undergo a bypass. Is this the only other option?

Please help, I''ve been wracking my brain trying to figure out how we did not forsee this. He had his last checkup with the cardiologist in October.

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Our expert says:
Expert ImageCardiologist

Dear Concerned Wife,

I am sorry to hear about your husband. Sometimes bad things happen to good people. I do not think you can blame yourselves in any way, and you could also not have foreseen this.

I have not seen your husband’s angiogram of course but from your description it sounds as though bypass surgery is the best option. The balloon/stent procedure was only partially successful, and also, as a general rule, diabetics do better with bypass surgery than they do with stent procedures. However, the decision depends on other factors as well, including how many vessels are diseased, which vessels are diseased, where they are diseased, and the quality of the downstream arteries. You should be guided by your husband’s cardiologist, who I’m sure will be happy to get second opinions if you wish.

It is about five months since your husband last saw his cardiologist so I would urge him to arrange a follow up visit. I hope all goes well with him in the future.

Best wishes, JT

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Our users say:
Posted by: Cardiologist | 2012-03-27

Dear Concerned Wife,

I am sorry to hear about your husband. Sometimes bad things happen to good people. I do not think you can blame yourselves in any way, and you could also not have foreseen this.

I have not seen your husband’s angiogram of course but from your description it sounds as though bypass surgery is the best option. The balloon/stent procedure was only partially successful, and also, as a general rule, diabetics do better with bypass surgery than they do with stent procedures. However, the decision depends on other factors as well, including how many vessels are diseased, which vessels are diseased, where they are diseased, and the quality of the downstream arteries. You should be guided by your husband’s cardiologist, who I’m sure will be happy to get second opinions if you wish.

It is about five months since your husband last saw his cardiologist so I would urge him to arrange a follow up visit. I hope all goes well with him in the future.

Best wishes, JT

Reply to Cardiologist

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