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On medicine for type 2 diabetes. Found blockage in artery. Should I go for open heart surgery?

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Cardiologist, Interventional
Practicing since : 1998
Answered : 410 Questions
I am 78 years old and have just been recommended to have open heart surgery. My Angiogram showed a 90% blockage near the end of the main descending artery. My ejection factor is 60%. I recently (past 6 wks) have been subject to angina pain if I exert myself, but do not have any other symptoms at this time.

I was diagnosed with Type II /Diabetes at about age 62 and have been on Lantus for that condition ever since. My dosage has climbed from 15 units to 90 units per day over the past 18 years.

My family history shows an age expectancy of about 83 years. My father died of a stroke due to blockage in the carotid artery. My mother died of stomach cancer and my paternal grandfather died from a stroke at age 83.

Q. With my family history I am trying to determine the risks of Open Heart Surgery at my age and if it is worth my doing it at this time, or can medical management help me to prevent a heart attack at the 90% blockage point for the next few years?

Posted Tue, 5 Feb 2013 in Hypertension and Heart Disease
Answered by Dr. Prabhakar C Koregol 1 hour later
Dear sir,

Thanks for on excellent description. Since you have new onset angina, which qualifies you for diagnosis of Unstable angina and you have 90% block in left main artery and LAD, CABG is the treatment of choice. Though medicines are required before and after the surgery, they are not enough on their own.

About the risk: With today's expertise and technology, CABG surgery is very safe and does not carry any morbid risk. Depending on the surgeon and institute, maximum risk could vary from 2-5%. However, risk of living with untreated left main disease is very high. So please have surgery done, only that can prevent heart attack and prolong life.

Hope I have answered your query. Let me know if you have any further queries.

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