We’ll today the jury came in and he definitely isn’t going to stent me.
Met with the surgeon and he thinks the way forward is bypass and not stents.
Reality is although I feel good in myself he believes stents may fail in a very short time and a bypass will become necessary.
Can’t say I took the news well and he did admit he was not a specialist in stents and I could be referred to that team, but on the evidence being presented from the angiogram and the panel that also looked at it he concluded that this was my best option.
So this post is to throw it open to the forum on experiences of a CABG, the good, the bad and the ugly if there is such a thing.
This isn’t for me to make a decision as it’s already been made by me and I only have to ring his secretary to confirm.
It’s about myself preparing mentally for the operation and being on the front foot for any challenges I may face especially recuperation.
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Angiogram three months ago showed severe five-vessel CAD with CABG recommended both by the interventional cardiologist and my regular cardiologist. Told no other options because the extent of the blockages and calcification.
Long story short, I was scheduled for CABG (quintriple bypass) -- packed, and everything -- and finally heard back from a interventional cardiologist at another hospital I had contacted a week earlier and almost forgotten about. He said he thinks I could get a good result with stenting.
Flash forward a couple of months later and I just finished my second PCI procedure. Six stents in all.
I'm certainly not saying that CABG is not indicated in your case. In fact it was a very reasonable option in my case and probably the majority of Cardiologist would've picked it.
However, stent technology has come along way in the last 10 years, and they are certain centers of excellence that are doing complex, high/risk stenting, where in the past only CABG would work.
You would have to find such a center and such a Dr to get a educated opinion whether stenting would work with you or not. Because places that do not perform these types of complex stent procedures will not recommend it. And certainly a CABG surgeon will not recommend stenting.
I'm not saying stenting is best for you. Both approaches have their pluses and minuses. I chose the less invasive approach with quicker recovery.
I was told there was a 1 in 10 chance one of my stents could close up within the next five years which would require another PCI to fix it. That was something I decided I could live with even though CABG should be a more durable solution, but then again you have to go through CABG!
I'm also well into my 70s and that impacted my decision as well. I'm from the US but I'm sure there are places in the UK that would give you this option.
if you do go with CABG, my research showed best results are off-pump surgery, using all arterial grafts. A combination sometimes hard to find, but I would definitely seek out off-pump . Good luck whatever you decide.
I had a 90% blockage on the first branch of my LAD. Because it was at the branch it couldn't be stented. 15 months and I am back to pre op fitness levels.
If offered the bypass take it hands down. When I was on the table being looked at the stent doctor and he said the stent would fail within a couple of years and would need to redone. I thought it was the end of my world.
Cabg recovery is pretty hard and the first few weeks were difficult. I have been discharged from my surgeon and my Sternum has fully healed post 15 months.
They used two stents on my LAD, prox-mid (95% blockage) one on D1, one RPL and two RCA prox/mid (95% blockage). Given a 10% chance I would have to return for a failed stent within five years. I accepted that in return for a less invasive procedure with fewer potential complications and faster recovery. If I was in my 40s or 50s, I might've decided to go with CABG..
Had a triple CABG a few days after an angiogram at the start of 2014. Was back to work in a few weeks and managed to walk a half marathon in six months (not my first). Apart from all the meds it's been life as normal ever since. Still get some nerve pain around the scar but would recommend the surgery as a long term solution.
it’s a huge undertaking, I’m 10 weeks post double CABG but don’t regret it for a minute. I feel so much healthier already, I know it’s a very individual recovery pathway that’s just me and I feel as though I was given the right clinical advice.
The surgeons wouldn’t undertake such a procedure unless there were very good reasons so my advice is to accept their advice. I don’t regret it and if I had to go through it again I would opt for CABG. It’s a long slow recovery but the improvements, for me again I stress, have been significant.
I had an angiogram with a view to stenting but during the procedure the surgeon decided that my arteries were too blocked for stents, stopped the procedure and told me an operation was required.
I was shocked. An operation? And fearful - will I be able to cope?
I said what will happen if I don't have the op?
He told me, quite bluntly, that the outcome wouldn't be good. And quite soon, too.
The hosptial staff made be relaxed and confident while I waited for the op. for a few days afterwards I was uncomftable but never in real pain. I went home a week later.
The first few weeks at home were challenging for me, mentally and I needed the help of my family and my GP.
Four months later I am walking further than I ever did before, going to the gym every week (I never did that before!) and generally feel great.
have it done whilst you have the opportunity. If surgeons aren’t sure of a positive outcome they won’t operate . Who knows how you will be if you don’t ? You could deteriorate and not be able to have one and where would you be then? I went through several stent procedures and they Eventually collapsed resulting in emergency's bypass . Yes it’s a big operation and it may take a good six to 12 months before you’re over it completely, but you will be mended ! It was just transformative for me after three years of stenting. You’re lucky - take it gratefully , wishing you good luck .
Just posted this on “loss of confidence “ thread that came up this morning ..
I had Nstemi July 2023, thought I was going to have a stent , no such luck .. had angiogram and the consultant performing it said I was going to have triple bypass . So utterly shocked . I cried like a baby in hospital that night after my family had left . I ended up with quadruple bypass ! I was fit and strong prior . Even on the day of my heart attack the doctor at hospital thought he was sending me home as I looked so fit and healthy walking around . It was the second blood test that confirmed it, first troponin count was 74, second one came back at 402 ! The doc was shocked as me and my wife. Post surgery I know I had a touch of PTSD for months , I couldn’t watch certain things on tv , I was vacant and numb to other things , I had no fear of physical threat to myself but I couldn’t stand the thought of something happening to someone else. The break through for me was going to a 3 day Americana music festival camping with friends . It was something I absolutely loved doing but I was so anxious about how I would cope with it all. I found that I wandered around on my own more than usual . I listened to a band and their music brought me to tears , it was so wonderfully joyful. Again I cried like a baby and realised how much I was enjoying my rebirth . It took nearly a year to understand and accept how well I was doing , how much I was loved and how much life there was left to live. I passed my full motorbike license tests , bought a Harley and then a touring bike , went on loads of rides , other music gigs , days out with my wonderful wife (not on motor bikes) other music gigs . It takes time . The 4 physical scars on my legs arm and sternum are there to remind me everyday what I went through and how they have healed . It happened . I love life and I’m so grateful for my rebirth.
I had a double CABG in March of last year and to be honest it was not as bad as I imagined it would be, it’s no walk in the park for sure, with the support and help of the wonderful NHS team at Wythenshawe Hospital and the follow up cardiac rehab support I feel better now than I have for years. I managed to lose weight & exercise regularly now which has no doubt helped. Overall I’m so glad I took the advice and had the op, hope that helps.
I had CABG x 4 in June. The anticipation was worse than the reality. Yes it is uncomfortable for a while and you feel a bit battered and bruised but home 5 days after op. Out for gentle walks a few days later and doing 12k steps again within 2 weeks. Rehab started at 6 weeks and all done and dusted at 14 and signed off by cardiologist. Leg wounds minimal due to keyhole and chest wound healed up really quickly. A little discomfort in the left breast where the mammary artery was diverted to my LAD but sure it will find a new source of blood in time. Sneezing is still uncomfortable but easily manageable with a firm hand press.Caveat: the above is me, others experience it differently.
I am 82 tomorrow. I had a bypass 4 years ago. I climb steep hills play tennis with people younger than me . I think the bypass was a very good option. Like any major operation be prepared for mental and physical adjustments but I found these fade when you realise one day you are alive and feel normal. I think exercise is paramount and taking care with what you eat. I never handled stress well but I’m still here . Your team will be amazing as they are so used to this op and they will be very encouraging and positive . It’s over and done now and I’m alive and lead a normal life 😺
I had a similar experience to you and others on here.
My angiogram showed 3 blockages (100%, 70-90% and another about 70%) and was booked in for a stent procedure.
Just before they were due to take me in they changed their minds and recommended surgery (after pressure-testing the arteries)
Yes to tears, hell yes to 8 months of ensuing worry on top of the 4 I’d already had. Long walks, deep thoughts etc.
I ended up having CABG x4 and the reality was way better than I could have imagined.
Yes there’s discomfort for a few weeks but the whole experience has left me feeling pretty privileged. Life-changing.
It wouldn’t surprise me, given the nature of athersclerosis, that I might need some stenting later in life but I sensed that, in my case, the chances of needing more work after CABG was less than needing it if they’d have stented.
Short term pain, long term gain if you will.
My op was in early Aug.
(New Cross Hospital Wolverhampton, staff on ward B8 and in critical care- I love you)
Had my 3xCABG 6 months ago. A little unexpected, some mild angina led to to echocardiograph followed by angiogram which in turn led to recommendation to operate.
The good:-
- glad they found the problems early before a much worse outcome could occur
- operation was not as bad as expected despite being s**t scared
- care teams were brilliant both in hospital and cardiac rehab
The bad:-
- waiting and wondering what will happen, including will I survive
- the strain it puts on your family - they worry more than you especially waiting for the surgeon to call and say it’s all gone well
- early days at home. Thought I’d be glad to be away from the constant monitoring but then found that it was weirdly reassuring and not being monitored 24/7 was quite scary - but you get over it eventually
The verdict:-
- glad to still be here
- happy to be recovering slowly but surely
- keen to learn lessons - less chocolate, less stress, more exercise
Dont try think too much about it, if you can. See it as a positive, 'you have had some engine' work done, which is not a bad thing considering the circumstances. My late dad, had a CABG when he was 55 gave him a new lease of life. What I found amazing about him post his operation - he didnt let it affect him in anyway - just did everything as before. Recovery was slow initially, but once the scars healed the change was beautiful to witness.
My personal take on all of this is a bit more philosophical. We are here on this planet for a finite time only and the day you are born the timer is set. The only thing you can do is make the most of it now. Spend more time with family, friends and get the positive energy of them. Do stuff that you have always wanted to do. Take your medicines as required and lead a healthy lifestyle. Try to be in the best shape of your life and you will feel amazing.
Fretting about what could happen tomorrow, next year,... nah not my play.
My husband had a quad CABG back in 2000 because stenting would have been too awkward. I'm pleased to say his grafts are still in very good condition. He has just had two MitraClips put on his Mitral valve as he is now, at 89, deemed too old for OHS.
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