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Criteria for choosing non-emergency CABG?

Worried_For_Dad profile image
20 Replies

My dad is scheduled for an angioplasty next week. His flow test and scans have revealed at least three significant blockages (over 70%) one of which is in his LAD. The doctors are planning to insert stents, but said the cath will give them a better sense of the blockages and if CABG is the better option. I’ve read stories online of people getting stents in 95% blocked arteries, which like the most blocked it could be without causing a heart attack. If they can stent a vessel with so much plaque, why would a doctor opt for CABG over stents?

Background:

My dad is 62 and just received a calcium score of 2200. He’s been having some pain between his shoulder blades while exercising for a few months now. His dad had CABGx4 while he was still alive. I know angioplasties are relatively safe and routine, but I’m really stressed and afraid of complications or open heart surgery. Has anyone had experience with this?

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Worried_For_Dad
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20 Replies
Smarticus profile image
Smarticus

Hi, I cant help you directly, but you sound like you are really up to speed with the information out there, try not to overthink it, despite heart problems not being talked about too much, these operations are routine - even open heart, and he will get excellent care from the NHS. Just try and relax and take one day at a time. HTH

Worried_For_Dad profile image
Worried_For_Dad in reply to Smarticus

Thank you - I think I’m getting really in my head about it. We have a whole week to wait 🤦‍♀️

MichaelJH profile image
MichaelJHHeart Star

After my initial angioplasty where they found four blocked arteries varying between 70% and 85% (LAD) they said they would have me back the next month for stenting. However, after further tests including a CT scan and echocardiogram peer-to-peer review decided a quadruple bypass was a better option and I was referred as the local cardiology unit do not carry out OHS (open heart surgery) I was referred to a specialist heart and lung hospital. As it is their day job these people are totally calm and professional. Some research suggests that CABG produces a better outcome than stents for the over 60s.

Thousands here have had successful OHS for bypasses and valve repair/replacement. If your father is referred for bypass I wouldn't worry. I would also respectfully suggest you avoid Google as it is full of out of date and incorrect information!

Worried_For_Dad profile image
Worried_For_Dad in reply to MichaelJH

Thanks Michael - did your doctors say why they thought bypass would be a better route for you?

MichaelJH profile image
MichaelJHHeart Star in reply to Worried_For_Dad

Basically they would expect a better outcome because I was over 60 and a Type I diabetic. Also because of the extent of the blockages it was unlikely they could 100% treat everything successfully.

A former colleague's father had a bypass on his fifties and is still doing well in his nineties. I will let you do the maths! 😊

Edsonmontibeller profile image
Edsonmontibeller in reply to MichaelJH

Hey, what kinda lifestyle his person adopted ? Does he use vitamin, meds?

I had CABG x4 five years ago aged 55 it was explained to me that because of the blockages it would need multiple stents fitting and that because of this surgery was the better option long term, in my particular case. Best of luck to your Dad, from what you say he keeps fit and this will stand him in good stead for whichever option is selected.

Worried_For_Dad profile image
Worried_For_Dad in reply to

Thank you I appreciate it

George249 profile image
George249

Good morning worried_for_dad, I to was worried for my father who was to under go triple heart bypass opperation this was to take place on a boxing day sum 30 years ago, he was terrified as we're we all. Secretly I cried my eyes out when I thought of the what if 's, nevertheless operation went a head & went well' he lived 25/30 years after. Then comes myself, aged 52 after a days work got home eating my dinner & then comes my heart attack but luckily seem to pass but with severe pain in my neck left arm etc, made my own way to hospital day after to be told sit there & don't move. Three night stay then angiogram at worst was hoping for sents but no was told I needed a triple bypass, was in total shock!!!

After a 5day stay in hospital I was taken to the theatre for my opp, that was 18 month's ago I'm back at work, taken up cycling & walking living life to the full. Please try not to worry yourself, your dad will be in very safe hands & looked after very well, the cardiac teams are fantastic.

Worried_For_Dad profile image
Worried_For_Dad in reply to George249

Wow I’m so glad you’re feeling better - that sounds scary!

AndyM69 profile image
AndyM69

Hi there

I know that bypass sounds frightening but as I was told before my op, for the professionals within the NHS, this is their bread and butter work!

I was diagnosed with angina and significant blockages 10 years ago aged 40 but no heart attack.

The heart is a very clever piece of machinery and although I had completely blocked arteries I’ve never had a heart attack and have never been rushed to A&E with any cardiac symptoms. I remember my cardiologist talking about collaterals which essentially took over when needed.

They talked about bypass then but decided to do angioplasty and I had 5 stents. Then in 2014 my angina returned and I had another 3 stents. Last year following a return of my angina they decided bypass was the only option.

I was due to have surgery in March but was cancelled due to covid. They resumed surgery in June and I had a quadruple bypass at the end of June so am 9 weeks post op.

I think everyone’s situation is different and the professionals will use the information they have to make the best decision for your dad, whether that be stents or bypass.

Major surgery is frightening but they know what they’re doing and will look after your dad. When I had my op there were no visitors allowed and that remains the approach at the hospital, to be honest, I really didn’t notice too much, I was far too happy on the drugs, drinks and food they supplied me with!

I hope everything goes well for your dad and if you have any questions on either subjects there are plenty of people who have been through the same experience.

Best wishes

Andrew

Worried_For_Dad profile image
Worried_For_Dad in reply to AndyM69

Thank you - so glad your operation went well!

Gail1967 profile image
Gail1967

I remember my surgeon saying- we do these daily- as the time for my cabg x 4 approached. Made me realise open heart surgery is pretty routine for them. I didn’t have option of stents but found post surgery at rehab I didn’t worry as much as those stented who saw it as a more temporary fix. I think you just have to put yourselves in the hands of the professionals- they really know what the best outcome is for each individual- good luck

Worried_For_Dad profile image
Worried_For_Dad in reply to Gail1967

Thank you ♥️

patience4 profile image
patience4

Hi, it’s always easy to say, don’t worry but I’ve had the treatment 3 x times. All successful and a relief that comes quite quickly. It can be emotional for a while you actually feel ones heart beating which for me reminded me of the fragility of ones life! If I had needed to have further treatment whilst being operated on, you’re in the best place for this. A small negative was being rather cold so socks and any extra clothes or blanket if possible.

All the best

Worried_For_Dad profile image
Worried_For_Dad in reply to patience4

Thank you - I’m so glad to hear it was a relief! I’ll warn him about wearing warm clothes

Janma123 profile image
Janma123

My hubby had his first HA when he was 58. He had a stent inserted immediately and was told he may need another as there was another artery slightly blocked but it didn’t warrant treatment at that time.

Fast forward 11 years and he woke one morning feeling ‘not right’. GP sent him to hospital and he was kept in. A few attempts were made at angioplasty but not successful so he had a CABG x4 in April 2018. It is major surgery but routine to the surgical team who carry it out. It takes time to heal and recover but it’s ok.

He’s doing ok now at the age of 71, still doing a few days work when he wants to!

Take care.

Worried_For_Dad profile image
Worried_For_Dad in reply to Janma123

So glad he's doing well!

Edsonmontibeller profile image
Edsonmontibeller in reply to Janma123

Hi, my question please, after his first HA did you continue going to cardiologist every year to make check up? Would it be possible to check any problem in order to avoid the second Ha ?

Janma123 profile image
Janma123 in reply to Edsonmontibeller

Hi, there was no follow up from anyone regarding his heart condition. He attended Cardiac Rehab classes for a few weeks, but that was all. He had regular checks for his T2 diabetes with the diabetic nurse but nothing apart from that.

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