I have narrowing of the arteries on one side of my heart, I’m told the heart itself is strong and can compensate for the weakness.
After my angiogram the doctor in charge of my case couldn’t decide on stent’s or a bypass when I received my doctors letter they had passed my case to a panel and this indicated a bypass and I’ve been referred to a surgeon to discuss it.
Now I’m fit and healthy, it’s taken 2 years to get to this point so my lifestyle hasn’t changed because I’ve had no chest pain and my original episode was just a discomfort in my chest which lasted about a week and then passed.
Also in earlier this year I went under general asthetic because with no diagnosis I was unaware of the later diagnosis.
I have a my first meeting this Thursday and would like to know if anyone thoughts on or experience of discussing the merits of bypass or stents with a surgeon and the outcome.
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Zerohere
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My experience was very similar to yours. I contacted the GP after I needed to take my spray for the first time ever and she sent me to the hospital that day for an assessment. I had thought it would be at worst a stent or even just different medications. Then when I asked the alternatives to a bypass the surgeon said there were alternatives but that they would be very stupid ones.
Zerohere seems to be not so far down the road as regards symptoms but not being a surgeon it is difficult to advise on the right course for them. I guess they would see a bypass as a more permanent and far reaching alternative to a stent or that further stents might have been indicated not far down the line.
I eventually had a quad bypass so my situation was not the same as yours. The alternatives for me were not as good or as long lasting as bypasses would be.
I suggest you ask about the various options and whether taking any of them would not be as good or as long lasting as another.
similar situation to me. Went in for stents and the procedure stopped immediately as my LAD was 95% blocked plus one other so advised would be quickly referred to consultant for CABG. That was in June and by August I had my double CABG.
I’m now fitter and feeling better than I have for many years. I don’t regret it for one moment. I hope your situation is quickly resolved.
After my heart attack I had an angiogram expecting the Cardiologist to say I needed angioplasty and possibly stenting. I was stunned when he said surgery. I immediately said I don't want to have surgery.
I then had several discussions with a surgeon, the Cardiologist who presided over the angiogram and the Cardiologist on the ward who is an angioplasty specialist.
What became clear is that there was a difference of opinion. I asked for my case to be discussed at the MDT and the result was that stenting wss the preferred option. So that's what I had.
It doesn't mean that the surgical option was wrong, just that the minimally invasive route was the best option for me.
It may be easier to get all this done as an in patient than as an outpatient.
I guess the call out here is everyone is different and there can be different solutions to a given issue. I had an NSTEMI in July 2022 and part way through the Angiogram the lead clinician said he was ‘not going to push through and go down the stent route. He was happy we could treat this condition with meds’. So that’s what we did. I’m no expert but trying to understand what’s happening is a good start and certainly helped me get to trips with things. Good luck!
I had Nstemi in July 2023, angiogram next day , thought I was going to have a stent . The doc performing the angiogram said “ well , it’s cabbage for you , no stents”
He explained that 3 arteries were, in his opinion , too blocked to benefit from stents and that it would be appropriate and better for bypass surgery and that it would be decided by a panel. I was utterly shocked ! Ended up with quadruple bypass . Glad I did , new pipes 🙌🏻🙌🏻🙌🏻 , loving my rebirth .
In my case I was told that the position of the blockages at junctions would make it very difficult to stent so I ended up having a bypass. Three years later I have now had a stent in a different area which was so easy compared to having the bypass.
I went in for an echocardiogram, admitted as a priority case and ended up with two stents a few days later. Come another echo pre-discharge and I was kept in hospital again and had CABG and AVR three weeks later. Just over 4 weeks from diagnosis to surgery!
Fitter than I have been for years and enjoying life again.
Went in for exploratory angiogram in Feb. Thought I would maybe need a stent or two due to angina. After procedure cardiologist explained he was referring me to surgeon for possible bypass! Saw surgeon a few days later, he explained that 3 arteries including LAD were badly blocked and bypass was recommended over stents (would need 5+ stents and outcome could not be guaranteed. Waiting list for bypass a was 8/10 months but luckily I could go private so 3xcabg was done in April. Now 6 months on and glad I went for bypass as feeling much better - no angina. Recovery has been a little harder/slower than anticipated but still no regrets.. Hope the medical team and you can reach the decision that’s right for you and that you feel better soon.
That’s part of the point I’m making now they’ve found the narrowing its taken 2 years to the diagnosis, I have had no symptoms since the initial episode.
Anyone who knows me would tell you I haven’t made any major lifestyle changes, my life has been normal all through this period.
I’m not fatigued, out of breath or experiencing any sort of chest pain or discomfort, I go to the gym workout fairly hard, eat and drink including alcohol as normal, and fly 5/ 6 times a year, needed a polyp removed earlier in the year and went under a general anaesthetic which has never been bought up to me, however when I tell health care professionals you can tell from tone and look on their faces a no no.
So I understand I need some sort of procedure but as I feel fit and healthy why a CABG and not stents.
So my post is aimed at people who’ve been in discussion with a surgeon and whether they had a say in their treatment and I appreciate every case merits a different solution, but did the surgeon take there views and concerns into account.
I appreciate all the posts made and the information garnered from them is invaluable and helps immensely with my own journey through this period of time in my healthcare.
About 20 years ago I was diagnosed with mitral valve prolapse. 10 years ago it had reached severe regurgitation, but I had no other symptoms. My cardiologist told me to clear my calendar and referred me to a cardio-thoracic surgeon.
My surgeon recommended waiting. At this point I kind of wanted to have it done and dusted, but my surgeon had some pretty sound reasons to wait. So I decided to wait. I'm not entirely sure if he would have been willing to go ahead anyway or not, so it's not exactly the answer to the question you're asking.
Fast-forward 10 years. Still no symptoms, but I had started to show LVH (when the left ventricle starts to grow to compensate for the leak). Cardiologist said it's time to talk to the surgeon again.
This time the surgeon recommended that we go ahead. Since this fit with the research I had read in the mean time, we didn't discuss it as much this go around, I just let him know I was on board and my schedule was free.
So again, not quite a direct answer. But I did at least feel that I was in control of what happened.
[One caveat: this was through the private system in Ireland. Not sure how different it would be (or not be) through the HSE or NHS.]
I’m sure your surgeon will give you his honest guidance and at the end of the day the decision will be yours. My symptoms were not major - some minor chest pains when out running. Checks showed high blood pressure and high cholesterol which started alarm bells ringing. There are many people who thought they were healthy on here but then had a heart attack. I was shocked with my diagnosis but also glad it had been found before I had a heart attack or worse. The idea of having a bypass was also a huge shock but I chose to take the advice of the surgeon who concluded that stents were likely to be a temporary fix whereas a bypass - although more invasive (and expensive!) - was likely to deliver a better long term outcome. Of course no guarantees in life whichever choices we make but my advice is to have an honest conversation with the surgeon put forward your viewpoint, listen to his views but then make your own choice. I’m sure you’ll do this anyway and I wish you luck and a good outcome whatever you decide. At the moment I’m glad I made the decision I did although it’s not been the easiest ride.
I only had angina symptons when running or walking up very steep hills (previously fit and active lifestyle)... going into my angiogram I thought it'd be a stent or two and I'd be on my way.
During the angiogram the consultant recommended a bypass as the best long term option (4xCABG in the end). A bit of shock, but my view was to trust his opinion as the expert - not sure if I would have had a choice if I'd not gone along with this 🤔?
I'm 5 months post op recovering well and starting to feel the benefits, exercising regularly (e.g 5-8km runs). CABG route is a long process and you have to have patience, good luck whichever way you go...
Hi, cardiologist doing angiogram just turned to me whilst still on the table and asked, 'Where would you like to be referred, The Brompton or Southampton?' No discussion. Didn't see him again until my post op discharge appointment 14 weeks after CABG x 4!
Not really, when you don't have a choice you can't fret over making the wrong decision. As for the location it didn't really matter so spur of the moment decision was for Southampton as it was easier for visitors. Had the paperwork 20 mins later through NHS app and asked nurse to decode it. Saw surgeon 4 weeks after angiogram and surgery 7 weeks after that, in early June. The anticipation of the discomfort after surgery exceeds the reality. Home after 5 days and walking the dogs (without holding them) shortly after. Rehab all done and now discharged (having never seen surgeon again or Southampton!)
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