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Suggest Treatment For Blocks In Heart When It's Functioning At 25%
Question: Hi Dr,
My father in law aged 56 had a heart attack and we took him to a multi specialty hospital. He was said to have had an severe attack and there where 3 blocks. One was long and the doctor suggested to go for a bypass instead on stent.
They wanted us to wait for 15 days before surgery. He was in medical care for 8 days and discharged from hospital with a date for surgery. But an cardiac echo was taken yesterday as the planned surgery was on Monday.
Now the doctors have informed us that his heart is weak and working on 25% and so we can not do the surgery and only a heart transplant is possible.
I am very confused to why the surgery was not done earlier and would like to have an advice on how to proceed further. Even is we are to wait for a donor, how long will he be in good health. Can he wait that long.
Is it advisable to take the risk of bypass now.
My father in law aged 56 had a heart attack and we took him to a multi specialty hospital. He was said to have had an severe attack and there where 3 blocks. One was long and the doctor suggested to go for a bypass instead on stent.
They wanted us to wait for 15 days before surgery. He was in medical care for 8 days and discharged from hospital with a date for surgery. But an cardiac echo was taken yesterday as the planned surgery was on Monday.
Now the doctors have informed us that his heart is weak and working on 25% and so we can not do the surgery and only a heart transplant is possible.
I am very confused to why the surgery was not done earlier and would like to have an advice on how to proceed further. Even is we are to wait for a donor, how long will he be in good health. Can he wait that long.
Is it advisable to take the risk of bypass now.
Brief Answer:
Not advised to take the risk of bypass now...
Detailed Answer:
Hi XXXXXXX
I have gone through the medical history of your father carefully and can say as following:
1. If surgery is not done within the first few hours, then, it is postponed for another 15 days. So, you can wait for another 15 days until intervention.
2. Meanwhile, I advise to continue taking current medications and follow the right diet changes.
3. I advise to wait for transplant for few months to years. Flu vaccination is also highly recommended.
4. I do not recommend to take the risk of bypass now.
Hope it answered to your queries. Let me know if I can be of further help!
Dr.Benard
Not advised to take the risk of bypass now...
Detailed Answer:
Hi XXXXXXX
I have gone through the medical history of your father carefully and can say as following:
1. If surgery is not done within the first few hours, then, it is postponed for another 15 days. So, you can wait for another 15 days until intervention.
2. Meanwhile, I advise to continue taking current medications and follow the right diet changes.
3. I advise to wait for transplant for few months to years. Flu vaccination is also highly recommended.
4. I do not recommend to take the risk of bypass now.
Hope it answered to your queries. Let me know if I can be of further help!
Dr.Benard
Above answer was peer-reviewed by :
Dr. Shanthi.E
Hi Dr,
Thank You for your response.
1) Why would have been the surgery not done immediately. Would there have been any reason behind it.
2) We where informed that the heart was functioning only 35% when we first admitted him. Doctors suggested a bypass at that time and the date was fixed.
where they wrong in fixing the date.
3) We where discharged few days before the fixed date of surgery as he was stable. Could we have done the surgery when he was stable. Why was the 15 days period needed.
4) After echo, 2 days before the surgery, they informed that heart is week and is functioning only 25%. What could have caused it to get week. This only gives us a lot of confusion on why he was not operated when he was stable.
5) Now is there no other option other than a transplant.
6) What are chances of living a normal life for a long period may be atleast 5 years or so with out transplant.
Regards,
XXXX
Thank You for your response.
1) Why would have been the surgery not done immediately. Would there have been any reason behind it.
2) We where informed that the heart was functioning only 35% when we first admitted him. Doctors suggested a bypass at that time and the date was fixed.
where they wrong in fixing the date.
3) We where discharged few days before the fixed date of surgery as he was stable. Could we have done the surgery when he was stable. Why was the 15 days period needed.
4) After echo, 2 days before the surgery, they informed that heart is week and is functioning only 25%. What could have caused it to get week. This only gives us a lot of confusion on why he was not operated when he was stable.
5) Now is there no other option other than a transplant.
6) What are chances of living a normal life for a long period may be atleast 5 years or so with out transplant.
Regards,
XXXX
Brief Answer:
Time needed til re-organisation of scar tissue...
Detailed Answer:
Hi back XXXXXXX
Thank you for your follow up queries.
1. If the surgery was not done immediately, it should be postponed to 15 days after the attack. This is because time is needed for myocardial scar re-organisation. Surgery cannot be done on scar tissue.
2. It is normal for the systolic function to get altered during myocardial infarction. In case of your father it has been decreased, suggesting for progress of disease.
If bypass was not carried out within the few hours after the attack, the bypass should be postponed after 2 weeks according to the protocol. This was what his doctor followed.
3. I am happy that he was discharged while his condition was stable. Once again, surgery or bypass cannot be done until re-organisation of scar tissue is complete (a 2 weeks time is needed).
4. Myocardial infarction has caused his heart to become weaker. It is normal to get a weaker heart after infarction. Once again, as mentioned earlier, 2 weeks is the time needed for scar tissue re-organization.
Once again, cannot run surgery on a scar tissue.
5. Continue with medications and diet changes. In rare cases, it happened that systolic function of the heart can be increased after a period of rehabilitation.
Implantable cardioverter defibrillators (ICD) should be considered at the end.
6. Life expectancy after 5 years is around 50% while it is lower (30%) after 7 years.
Hope it answered to your queries!
Dr.Benard
Time needed til re-organisation of scar tissue...
Detailed Answer:
Hi back XXXXXXX
Thank you for your follow up queries.
1. If the surgery was not done immediately, it should be postponed to 15 days after the attack. This is because time is needed for myocardial scar re-organisation. Surgery cannot be done on scar tissue.
2. It is normal for the systolic function to get altered during myocardial infarction. In case of your father it has been decreased, suggesting for progress of disease.
If bypass was not carried out within the few hours after the attack, the bypass should be postponed after 2 weeks according to the protocol. This was what his doctor followed.
3. I am happy that he was discharged while his condition was stable. Once again, surgery or bypass cannot be done until re-organisation of scar tissue is complete (a 2 weeks time is needed).
4. Myocardial infarction has caused his heart to become weaker. It is normal to get a weaker heart after infarction. Once again, as mentioned earlier, 2 weeks is the time needed for scar tissue re-organization.
Once again, cannot run surgery on a scar tissue.
5. Continue with medications and diet changes. In rare cases, it happened that systolic function of the heart can be increased after a period of rehabilitation.
Implantable cardioverter defibrillators (ICD) should be considered at the end.
6. Life expectancy after 5 years is around 50% while it is lower (30%) after 7 years.
Hope it answered to your queries!
Dr.Benard
Note: click here to Consult a cardiac surgeon online. to know the best treatment option for your heart-related issues
Above answer was peer-reviewed by :
Dr. Shanthi.E
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