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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For 100% Heart Blockage?

my mother in law when to emergency room she was told had a minor heart attack she had 100% blockage the doctors placed one stent. Now the question is should she have more stents placed or have bypass surgery but the the surgeon suggest she needs more stents placed becuase her left artery is blocked the right artery is blocked and the middle artery is blocked but its not really needed. Is this the best decision to have stents placed or should she have bypass surgery? Her medical history is 61 year old african american, highblood pressure, and diabetes.
Mon, 6 Apr 2015
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Diabetologist 's  Response
Hi,
As you have mentioned about your mother in law-
61 yr, Diabetic, Hypertensive, African-American.
She had heart attack for which she must have underwent coronary angiography and subsequently angioplasty (stenting of 100% blocked vessel which is called as culprit vessel as blockage in that vessel is responsible for symptoms of heart attack and ECG changes)

Also there are blockage in other vessels as you have mentioned there is need for revascularisation procedure either stenting or coronary bypass surgery.

Either of two procedures will be selected depending upon
1) age of patient usually in young patient stenting is preferred.
2)nature of blockage like in patients with long standing Diabetes there are usually diffuse blockages (long segment of vessel is narrowed) in such patients bypass surgery is preferred over stenting.
3)Number of blockages more the number bypass is preferred.
4) Other comorbid conditions.
5) Duration of hospitalizations usually less with stenting.
6) In case of Calcification of vessels bypass surgery is preferred.
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Suggest Treatment For 100% Heart Blockage?

Hi, As you have mentioned about your mother in law- 61 yr, Diabetic, Hypertensive, African-American. She had heart attack for which she must have underwent coronary angiography and subsequently angioplasty (stenting of 100% blocked vessel which is called as culprit vessel as blockage in that vessel is responsible for symptoms of heart attack and ECG changes) Also there are blockage in other vessels as you have mentioned there is need for revascularisation procedure either stenting or coronary bypass surgery. Either of two procedures will be selected depending upon 1) age of patient usually in young patient stenting is preferred. 2)nature of blockage like in patients with long standing Diabetes there are usually diffuse blockages (long segment of vessel is narrowed) in such patients bypass surgery is preferred over stenting. 3)Number of blockages more the number bypass is preferred. 4) Other comorbid conditions. 5) Duration of hospitalizations usually less with stenting. 6) In case of Calcification of vessels bypass surgery is preferred.