I just had an angioram and was told that there is moderrate to severe Stenosis LAD disease. The cardiologist told me that they may offer me a CABG or probably a stent and will let me know once they have decided. My initial symptoms were chest discomoft sometimes during the day and heart racing for few seconds when I am trying to sleep. My GP has put me on Asprin 75 mg, Ranolazine 375 mg twice a day. I am not sure what will be the treatment offered to me and getting bit nervous about going for a CABG. I am 51 and generally healthy. All this has happened so quickly that it's bit difficult for me to get terms to this whole situation. How risky is CABG in general?
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I had a single bypass in 2017 apparently the blockage was in a difficult position which is why they bypassed it. They used the mammary artery so it was quite straightforward,I recovered very well and was discharged after 4 days from ITU (they needed my bed)
Last year I had 2 stents fitted and was discharged the next day.
A bypass is open heart surgery so not to be played down, it is major surgery but it is something the cardiac surgeons do on a daily basis. It was 6 weeks before I was discharged by the surgeon (not the cardiologist) and allowed to drive and of course there were things you have to avoid (lifting anything heavy, even a full kettle). Remember though it is life saving!
We are lucky to live in the day and age when we have wonderful surgeons who really do know what they are doing.
Do you know, I haven't got a clue!! I was first down (I had been cancelled 2 days before after taking my premeds, very last minute) I remember being wheeled outside the anaesthetic room but can't remember anything else, that total Friday was a blur. All I remember was being told when back at ITU that when the green light came on the morphine drip I could push it!! I actually don't remember being in pain, but every time that green light came on I pushed the button, however I think your guestimate is probably about right.
Hi Gavs, I had chest pain in October 2001 at the age of 46 , I’m female. This then became unstable angina and because of the position of blockage had to have a double bypass urgently in January 2002. 20 years ago. I was fairly fit until the October. I then had a stent in 2005. It is a shock but it is lifesaving. All the best.
Hello
I remember having my Angiogram and thinking they would say a stent and when they came back saying Triple heart bypass I could have passed out
I know we cannot help but overthink sometimes I am terrible at doing so but I sometimes have to have a stern talk with myself and say worrying is not going to change a thing whatever they come back with me worrying won't make them say anything different
But be reassured whatever they come back saying you need it will be in your best interest and to make sure you carry on been fit and healthy and if it was a Bypass from the most anxious person there possibly is trust me when I say it is not anything to worry about you would be in the best hands
You just need to focus on getting their response , getting the treatment you need , recovering and then enjoying life which you will
Everyone is great on here and will give you any advice or support you need so you are not alone x
Oddly enough I was more worried about the angiogram than I was about the bypass. I think being awake during a process frightens me more than being under general,
I was sedated when I had the angiogram and I think because I had 3 heart attacks I just wanted to know the outcome even though I was hoping they were just going to say a stent Hope you are keeping well x
That made me giggle as I remember being taken off the angiogram table & thinking well what a fraud I am I obviously don’t even need a stent- to then be sat in the wheelchair & told you need a bypass!!! Surreal moment!
I went in as a day patient for my first angiogram in 2017 onto a day ward. there were 6 of us to be 'done' that day. We were just separated by curtains. All the angiograms are done first then the cardiologist visits each bed in turn and tells them what he found. Obviously with just a curtain dividing us you could clearly hear what was being said. Out of the 6 patients I was the only one who needed surgery!! Just my luck!!
No, he didn't save the best to last!! LOL. We were in numbered beds and he started at 1 and worked his way around. There was one woman who kept wanting to go outside for a 'fag'!!
I had an angiogram last October hoping for a quick stent. When they finished halfway through the writing was on the wall. A double bypass was recommended instead due to 2 severe LADs. Took a few weeks to sink in but I am now just putting my trust in them, I now feel OK about it. Should happen next week 🤞
Before a CABG operation you will have to sign a surgical consent form. You don't just have to give consent, you have to give informed consent, which means you have to be informed about the risks of the operation. Consequently you'll be told that that there's a 2% risk of a bad outcome, ie a stroke, heart attack or even a fatality, during the operation.
However, this 2% figure is an average, it meets a legal requirement but it tells you very little about your own personal risk. If you're mathematically minded you can dig deeper into the statistics in the EuroSCORE II Report, this is the original source for the 2% figure. You'll see that there's a very wide spread of risk, I forget the precise figures, but the range goes from something fairly negligible like 0.15%, up to a truly terrifying figure of about 17%.
Not too many surprises about what drives this huge difference in risk profiles, age and co-morbidities are the main ones. I think from memory that the average age for open heart surgery is something like 68, younger than this and your personal risk is less, older and it's more. Likewise, if you have other medical problems then your risk is higher, if it's just angina then the risk is lower. If you're significantly away from the average and are concerned then talk to your surgeon, it's your life, you deserve to make the decision armed with all the facts.
One thing for example that did surprise me when I dug deeper into EuroSCORE II before my own operation was that weight has very little impact on your risks during the operation. Let me be clear, being overweight is a huge risk factor for having heart disease in the first place, but being overweight has almost no influence on your chances of surviving open heart surgery.
One final point. A successful CABG operation can be absolutely transformational. For many people it removes all symptoms of angina and can leave you feeling ten or twenty years younger. That was my experience, after the initial recovery period I felt full of energy, and I've radically changed my life style and have maintained those benefits for over three years now. I hope that a combination of life style changes and medication will give me many more years of this significantly higher quality of life. But remember that stents or a CABG operation won't actually cure your underlying heart disease, so if you suspect that you're the type of person who will be unlikely to take the medication or make life style changes, then there's less incentive to undergo the risks of the operation because there's a much greater risk that the symptoms will return within a relatively short period of time.
For me the risks of the CABG operation were well worth taking and faced with the same choice again I wouldn't hesitate. But other people may make different choices, I respect that.
Open heart surgery is a serious matter and these risks are material. The average 2% risk for example means that, unless you've lived an exceptionally adventurous life, this will be the most dangerous experience you've ever undertaken. For example, you'd have to climb Everest three times to experience a similar risk. But as I said, when a CABG operation works the results can be amazing, and if you are prepared to work hard at staying healthy afterwards, then there's a massive and enduring potential upside to be gained.
Thankyou so much Chappychap for the detailed information. It's bit difficult for me to digest the fact I will be facing this difficult situation at the age of 51. May be it's because just 2 days has passed since I got this unexpected news.
Stroke, cardiac arrest or death is part of the information prior to an angiogram, I had a stroke following my angiogram, luckily I had very minimum long term effects.That said, just to confirm your post, they let you know all the consequences as you go and bearing in mind if you do nothing the outcome is likely to only go one way, it leaves you with only one choice!!
I too was 51 when I had my bypass- thought they may say I needed a stent as my brother had a couple before- bit shocked when they said bypass! Mammary used for 2 then vein harvested from leg for other 2. Recovery good. It’s hard at 51 when you think you’re fit & well but the surgery is routine for them & I like to think my plumbings been fixed now rather than anything temporary. Don’t under estimate how you may feel though as my physical recovery went better than my emotional- be kind to yourself & take the time needed.
Hi Gavs, I was 45 when I was told, during the latter part of my angiogram, that I would need a bypass. Bit of a hammer blow as everyone kept telling me it was highly unlikely their would be anything wrong 😂! I had a double heart bypass just after turning 46. When meeting my surgeon and signing the forms I was told it was a 1% risk of a severe adverse reaction which I personally considered an acceptable risk. The first month after being told was a massive roller-coaster of emotions until I got used to the idea. However, given how ill I was with angina and how terrible I felt, how low the risks were and how much the operation could change my life I got used to the idea and found the worst part was actually the month before my op being in limbo waiting for a date. The recovery can be long and hard but in the long run I felt world's better after the op.
I had mine in June 21, cabgx4 I was originally going to be given a angio and stent, but they squirted the goop looked at the big TV and pulled out the probe.Four days later I had my bypass, and went back to light work in twelve weeks, I am still not fully back to normal but I am definitely getting there.
It a major surgery, let's face it out harts are kept in a bone cage for a reason.
But the surgeons do it almost daily and it is a routine procedure.
I feel better than before I had it and would not be afraid of another if it was nesecerry.
Cardiologists reach for the drug's first,then the use stents and as the final step open Hart surgery,if they say that you need it, the alternative is a bit final.
They don't waste surgical slot's, it's given to those who really need it.
If you are really worried, ask your surgeon, they will be honest about all of the risks involved, and the options involved in not having it.
I had a stent at the time that I had my heart attack which was caused by a blood clot in my RCA which was quite narrow. The angiogram showed some narrowing in the the vessels on the left side of my heart. Being fit on account of my interest in hill walking, I was referred for bypass surgery, which I must admit initially was a bit of a shock. I was in a haze anyway having had a heart attack with no previous symptoms.
When I met with the surgeon he told me the risk averaged 1%. He estimated the risk to me was considerably less on account of me being fit and told me that a bypass (he proposed a triple, including a bypass of the stent) should see me okay for at least 25 years. Alternatively he could insert additional stents into the narrowed vessels, but expected me then to need further intervention within 10 years. For me it was an easy decision.
I recovered from surgery quite quickly and was back on the smaller hills after 3 months, as soon as I could drive and carry a backpack. I then built up my stamina and was back on the larger hills 6 months after surgery. I now climb even bigger lumps of rock with several Munros ascended last year.
Whatever course of treatment you are offered, be it stents or a bypass, I would encourage you to remain positive. It is key to getting over this, both mentally and physically.
Good luck Gavs!!!look after yourself.. and best wishes for the future, keep us posted and you'll get support from all the kind, thoughtful people on this forum 👍👍
My opinion is, if I need something done to keep me alive then get on and do it.
I had a heart attack December 2016 (at 63 yr old).
I was treated for stable angina.
In the run up to an angiogram I was told of the risks of having an angiogram. But I was also told that the risks of not having it was worse.
No brainer, I had the angiogram.
After the angiogram I was told I had very serious heart disease. And they were having a consultation to see if I was going to have stents or bypass surgery.
I said do whatever you need to do to keep me alive.
I ended up having 5 stents. 4 at one time and the last one a month later. On both occasions I was eating a sandwich just after and in and out in a day.
Eight months later I started having stable angina again.
Another angiogram was on the calendar. I had had 4 previously including angioplasty's.
They stopped the angiogram and told me there was no point in carrying on. Apparently my arteries were in a mess again.
I was asked how did I feel about having a bypass.
I said do whatever you need to do to keep me alive (although I did shed a tear at that news).
A bypass was scheduled for late March 2019. I didn’t make it. My angina turned to unstable angina and my doctor sent me to A&E early March and they kept me in.
My condition was worsening so they sent me to another hospital for the bypass.
After a few "episodes" I was taken to intensive care on the Friday to keep me alive with drips and I don’t know what else until the Monday morning when they could do the surgery.
When I was taken to surgery I was told that I was scheduled for 6 bypasses.
Then the anaesthetist had trouble with one of the machines in the room to the side of the operating room. So he said they are going to take me straight into the operation room before knocking me out.
I said do whatever you have to do just get me the hell in there and fix me.
I would have walked into the operating room if I had to!
I ended up having a quintuple bypass (CABG x5). One stent caused a problem for the bypass (or something?).
The next morning I was walking on the spot. By lunchtime I was back on a surgical ward.
Three days later I walked into the ward that I was in before going to intensive care. The physio was carrying my drips. As I went in I said in a loud voice "stand by you beds lads". As I was walking back out I said "I can’t stay here all day, I have places to go, people to see". It got back to me later that that gave the guys a boost to see me walking around so soon after major surgery, all be it a little shaky. 🙂
Five days after the op I was home eating a lovely steak and drinking a cheeky little red. And it was wonderful.
Since then I’ve had my ups and downs as we all do but I’m here. I’m a survivor and I’ll do whatever it takes to keep it that way.
The thing is… my father died of a heart attack at 53, I was 17 yr old. My brother died at 59. I consider myself very lucky to be in the system and able to have had stents and bypasses.
So in my opinion do whatever it takes to survive.
Since then I’ve seen my son get married, heard my granddaughter call me granddad for the first time and my picture folder has loads of photos that I was lucky enough to be there for.
And also, I can show off the scar on my chest to anyone that wants to see it, much to my daughter and wife’s eye rolling and tutting 😂😂😂😂
All the best to you 👍
My name is Bond, James Bond and I take my aspirin shaken not stirred 🍸
Back in 2013, I had a quad CABG and mechanical aortic valve replacement the day after my 56th Birthday, (admitted on my birthday). My surgeon told me I had a 1% risk of death, 1% risk of stroke and 1% risk of some other serious problem that would have long term or lifelong consequences. I've not come out of it totally unscathed. I get the occasional missing beat now and that happened while I was recovering in a ward. The first time it happened, my heart stopped for about 2 seconds and that scared the poo out of me because my heart rate was about 110 BPM at the time. They put me on a 24 hour ecg recorder and found many of the missing beats on the recording but told me not to worry about it. Even to this day I get missing beats and small bouts of what I believe to be atrial fibrillation, but I'm not dwelling on it. My fitness was massively improved a few months after the op and I would have been dead within weeks if I hadn't had it, so there was no choice for me. Glad I had it done. Hope everything goes OK for you.
I had 5 angios before I was offered a cabg.I decided to go for it because I was fed up with continuous trips to hospital and constantly having to take gtn spray .
Best decision I ever made ! I’m now 7 months post op and recovered very quickly and now back to feeling how I used to before all my heart troubles began .
Can’t thank the surgeons enough for my new lease of life 😃
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