couldn’t fit a stent, what’s next? - British Heart Fou...

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couldn’t fit a stent, what’s next?

Paulsmith12 profile image
20 Replies

Hi,

in February I had a big heart attack after suffering a few in the past. I was admitted to hospital where they tried to fit another stent but couldn’t due to calcification in the LAD.

I was discharged with new medication, however I’m anxious to know what’s next. Do I need bypass surgery? With the NHS in its current state will they leave me on a waiting list? I feel unable to leave the house.

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Paulsmith12
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20 Replies

Dear Paulsmith12

A warm welcome to the forum , I hope that you find it as supportive and informative as I and many others have.

I am so sorry to hear your news and the fact that the stent placement was not successful.

You may well have been discharged from hospital with new medication { which you haven told us the name of} but you will have a follow up with your Cardiologist dept to discuss what other treatments are available to you.

Of course it is a worrying time for you and your loved ones, it is something so many of us can understand.

Contact your GP and find out the results of the Angiogram {He/She will have a copy of it} and ask them to push for more information as you cannot go on like this with anxiety that is making you housebound.

Take care and please keep us informed.

Paulsmith12 profile image
Paulsmith12 in reply to

thank you

I’m on clopidogrel

monomil xl

nicorandil.

My discharge notes say

LAD moderate/severe calcific alteroma

LCx small non dominant severe alteroma

RCA severe calcific alteroma

PLV giant aneurysm

IVUS LAD couldn’t pass

If that’s of any use? It doesn’t sound good.

I was supposed to have follow up within 3 months but finally have appointment end of June. Would I already be on a waiting list for surgery, or will they potentially put me on one in June?

Thanks

in reply toPaulsmith12

It is only something that you can take up with your Dr, but its rare { judging by others experiences , including mine } that it is not discussed with you about having a bypass first and not just placed on a list, because you have to except and agree first.

But again your Dr/Cardiologists secretary / team should have more information for you.

You certainly will have some more tests needed for the operation when you accept it.

Take care

I had an NSTEMI five years ago and spent a few days in hospital during which I had an angiogram. They found all of my heart arteries were moderately or severely blocked but it was decided that is was unwise to stent one in particular, which would have otherwise been stented, due the position of the artery and its blockages, because of the risks involved. And last year after another angiogram the same applied although things were substantially the same in terms of blockages. Anyway the point of all this is that I am still here and still enjoy life and do stuff, so my suggestion is to accept your situation as best you can, rely on the health professionals and what they are doing for you, and take each day as it comes and make the most of your life.

Sodp profile image
Sodp in reply to

Hidden that's very encouraging, good to hear that everything sort of stayed same. May I ask you what did you do ..was that a medicine or any other things together such as lifestyle, supplements etc helped you stay same. I had stents fitted but I have few with 20-40% not stented..hoping to keep them at bay. Just wanted to see what may have helped you.

in reply toSodp

Sodp About 25 years ago I was told my cholesterol was about 9, so after an abortive attempt to reduce it significantly by 'life style' mostly diet during which I only achieved 6.5, I was put on statins, and so for 20 years or so was on 40mg Atorvastin and that got my count down to about 5 to 5.5. Then post NSTEMI I was put on 80mg which brought it down to about 4.5. The best I ever achieved was last year which was about 3.8, and the GP attributed that to me losing 13kg, which I have more or less sustained with a current BMI of about 25. But other than that I have a good varied diet and have always had that in my adult life, which takes on board the BHF recommendations but not to the letter, and I am as active as I possibly can be, swim, cycle walk, and other stuff, although I can no longer be sporty as I was in my earlier years. I stopped smoking over 45 years ago, but I do drink alcohol, some might say too much. That's about it. Anyway my theory for what it's worth is that most of the plaque laydown occurred before I took statins, and the little apparent change over the last 5 years is down to max dose statin. Apparently that works for me. 👍

Sodp profile image
Sodp in reply to

Thanks Hidden good to know statin are quite effective, together with your lifestyle working well. I had max 6.5 but my cholesterol down to 2.1 ..ldl .8 of course lifestyle and rosuvastatin 40mg highest dose. Good luck 🤞

Thanks

Chickenlou profile image
Chickenlou

My fiancé went for a stent but they couldn’t place it (due to amount of atherosclerosis and the fact his arteries were too “wiggly.”)

He was told that it was likely he would need a bypass. His case was discussed at a multi disciplinary team meeting and then he saw the cardiologist again who confirmed the bypass.

The failed stent placement was in early September and he had his bypass the following January.

Hrty profile image
Hrty

Similar situation to Lowerfield except my NSTEMI was last November. I wasn't stented due to the position of the blockage at/near the junction of a couple of arteries which would have required a kissing stent. Was told I have "interesting" arteries. No mention of a by-pass and told I had a good pump, am low-risk (crossed fingers) and should make a good recovery. Told by Cardiologist and Rehab Nurses that stenting isn't a cure as such. Completed hospital rehab and am now onto Phase4 rehab, which is basically indefinite, and also enjoying life.

Sounds like you need more discussions with your Cardiologist and/or Cardiac Rehab Team as to what happens next for you. I was contacted by the latter within a few weeks of leaving hospital. Have you had no follow on contact?

Good luck

Harefieldfan profile image
Harefieldfan

hi Paulsmith12. I also had heavy LAD calcification which prevented stenting. I was referred to Harefield hospital, where a wonderful surgeon drilled it out via a procedure called rotablation. And the stent went in. Can you try to request this? No bypass necessary. Best of luck!

ChoochSiesta profile image
ChoochSiesta

I had 3 that were severly blocked. They said they could do stenting. However, a bypass would be a better option which they did in February 2022.

Dralex profile image
Dralex

Hi Paulsmith12, I'm with Harefieldfan's response above. Like you, I had severe calcification and initially bypass surgery was contemplated. However, another consultant looked at my case and thought rotablation was a better option for me. Went into St Thomas' and had the affected areas drilled out, five stents inserted, and back home the next day. This was 4 years ago........

Certainly worth a mention to your cardiologist to consider this procedure for you.

MWIC profile image
MWIC in reply toDralex

that’s pretty incredible isn’t it 👍

Sodp profile image
Sodp in reply toDralex

Dralex that was amazing, I had my stents (4) done last Sept. Going through many medicine..doing my exercises, walk and healthy eating. I do still feel pain in body. I am very sensitive to any pain or tingling and sometime make me anxious.. still worried . Just wanted to ask you how do you feel now. Are you sensitive to pain and notice a lot? If not how long after you didn't notice or sensitive to pain? I am just wondering will feel bit normal after sometime

Dralex profile image
Dralex in reply toSodp

Hi Sodp,

yes, like most of us, for a couple of years or so I did experience periods of chest pain, tingling, etc., which gave me some concerns and anxiety. I ended up in A&E on a number of occasions, but each time I was discharged with no further treatment.

In February 2022 I was diagnosed with paroxysmal AF, for which I am on bisoprolol and warfarin, in addition to aspirin to protect my stents.

Earlier this year I had a stress echocardiagram, where no new abnormalities were detected, and showed an EF of over 55%. My cardiologist (the one that did the rotablation) said he was very pleased with the results, and so am I!

Sodp profile image
Sodp in reply toDralex

Dralex thanks mate, that was a good news..ef improved to 55% , may I know what was your ef initially. Mine is 40% and 6 month ultra didn't show much improvement remained at 40% . Even I feel good and doing my exercises 3 PW and walk 7 days. Hopefully next check up will see some improvement. Yes I am very sensitive and aware of any pain or sensation, hopefully I will not be so overtime. I always wondered if I had the same sensation prior to this event and I may not have noticed.

Hope your medicine with lifestyle helping you with paroxysmal AF . Thanks 🙏 for your response it's very reassuring, I just wanted to be normal..

Dralex profile image
Dralex in reply toSodp

Sodp, originally my EF was below 50%. From what you say, you are doing all the right things, so hopefully you will see some improvement. Being sensitive and anxious about any new twinges and pain is perfectly normal, but I think you will in time learn to ignore these minor events. You probably did not notice them before your stents were inserted!

Sodp profile image
Sodp in reply toDralex

Thanks Dralex no I never did, I still wondering it may have happened it's just didn't notice it. I am hoping my ef will improve overtime trying to do best I can. 🙏 Thanks quite reassuring.

momander profile image
momander

Hi Paul,What did they say before they discharged you?

I had a double cabg 17 weeks ago due to stents having collapsed. I was suffering from angina all the time. They said they could treat it with medication but that would only work short term. I was lucky in that I was kept in hospital till there was a space on the surgical list. I would perhaps phone the hospital and try to get clarification? That way it will put your mind at ease. What meds have they put you on?

It may be that they think you will be absolutely fine with medication!?

pasigal profile image
pasigal

Paulsmith12 Wow, I'm really sorry they left you hanging like that. I think you have to be your own advocate here and seek more information, including results of any tests they did. I would be surprised if the follow up to a myocardial infarction is just different medication. Hang in there!

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