Can a CABG fail?

[DavidOverton]

Hi, about 20 months ago I had a 4x CABG following a heart attack and stents that my body rejected. Life was good. 8 weeks later I was doing DIY and my energy levels were up and high. Around Christmas I started to get chest pains frequently and exercising got a lot harder. Walking up 2 flights of steps has me breathing hard and I often nap in the afternoons again. I saw my consultant about it recently and they told me that perhaps the CABG had failed. They put me on nitrates and told me to stop trying to go to the gym while an appointment for a angigram has been scheduled.

The nitrates are working - I don't suffer chest pains now when walking, although I still get quite out of breath.

I was wondering if anyone else had had a cabg "not work"?

thanks

David

[Chappychap]

I think there are two answers to your question David.

The first answer is that yes, a CABG can "fail". I've heard that as many as 15% of by-pass operation fail within the first year, my cardiologist said this was an outdated statistic but he couldn't give a more up to date figure. Apparently the harvested veins are extremely susceptible to physical damage during the operation, this is why the surgeon will remove a couple of feet of vein from your leg in order to harvest just a couple of inches. The surgeon wants a long length of vein from which to select the very best few inches. But even so the surgeon runs a high risk of damaging the vein, and additionally the vein could have been diseased in the first place.

A vein is a poor substitute for an artery, it's not designed to handle the higher pressures and turbulence found in arterial blood streams. Amazingly the harvested vein will change its physiology after being grafted as an artery, and in time develop the stronger muscle walls of a true artery. However, this doesn't happen immediately and the first year is the risk period. There have been a few forum members who have found themselves in this difficult position and have been brave enough to share their experiences.

The second answer is that atherosclerosis (the disease that caused the blockage in the first place) is incurable. Consequently any by-pass or stent procedure can never deliver a "cure". All they do is re set the clock and buy us some time in the hope that medication and life style changes will prevent our atherosclerosis making too much progress too quickly. In this sense you could argue that given enough time all by-pass operations are destined to eventually fail, this is especially true as the biggest risk factor of all is simply age, so with every passing year our chances of suppressing our atherosclerosis gets worse.

[stevejb1810 in reply to Chappychap]

Top reply 👍

[Jonboy12]

Hi David

Yes unfortunately this has happened to me ,I had a quadruple bypass in March 2018 and all was well until approx May 2018 when original symptoms returned( please see my posting Blockages After Bypass )

Unfortunately I am now been treated by medication only and my lifestyle has completely changed unable to work or drive .But please don’t be put off by my story there are more positive results than negative ones I was just unfortunate .John

[sos007]

I had a triple bypass in March 2015. At my one month check up, my cardiologist informed me (following some tests) that my bypass had failed (male, aged 52 at time of surgery).

The vein graft was completely occluded and the arterial re-routing bypasses, had narrow openings where they connected to the heart.

I subsequently required 4 stents to open the blocked and narrow arteries.

The best solution is always a natural one.

Aggressive lifestyle and dietary modification.

Elimination of sugar, simple/refined carbohydrates and processed foods.

A whole-foods, plant-based diet (Mediterranean Diet) with lots of legumes is best.

That's what I did and within 10 months following my changes, my weight normalized (lost 40 lbs) and i stopped all medications. I have been free of meds for 3 1/2 years now and feel great. I'm in the best shape of my life.

Good luck.

[stevejb1810]

Excellent response from Chappychap and those who have experienced the less than positive outcomes of CABG. Their collective responses just go to prove that surgery is not a panacea. Whilst outcomes of CABG are improving in leaps and bounds, there are no guarantees here.

[DavidOverton]

Hi all, I wanted to share my experiences. Firstly thank-you for all the replies. The idea that things could "go backwards" was very scary. The good news is that things have stabilized. My fitness levels are better than when I wrote the above. I've been able to do extensive remodelling of my garden and while carrying 25kg bags of sand/cement etc around can get tiring, I do not think my heart issues show themselves until I've moved 10 bags on the trot.

Thanks for all the support.