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Is It Possible That Somebody Has To Undergo Same Three Arteries Bypassed Within 15 Months ?

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Posted on Wed, 25 Apr 2012
Question: I am very worried. My boyfriend, who is 49, has had a rough 2 years. He had two heart attacks. Then, in February of 2010, he had undergone a triple bypass. Three months after the bypass, (May of 2010), he had another heart attack. His surgeon advised him to get, yet, another triple bypass 2 months ago. He refused to comply, stating he had too many things to do.....last week, he had two separate angioplasty procedures, where they placed stents in his arteries. This was to no avail. Today, he was just admitted, minutes ago, to the the hospital. His doctor was finally able to pursuade him that this was the only option. So, he will undergo, yet, another triple bypass surgery tomorrow. So, my question is, how high-risk is he? I am scared to death of this. And, to make matters worse, I am in Chicago and he is in Toronto ON. My passport just expired and I am worried sick and feeling stuck and helpless. I have never heard of someone needing to have the same three arteries bypassed within 15 months. Please provide some medical information for me. He tells me as little as possible so as not to worry me. (Impossible, since I am a nervous wreck right now.) What can you tell me?
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Follow up: Dr. Sapan J. Pandya (9 minutes later)
Oh...not really a question, but my boyfriend is in great shape in terms of wieght proportionate to his height. He is 6'1", 200 lbs. He doesn't have an ounce of fat on him, no beer belly.....has always worked out and has been in great physical shape. From the outside, you would never suspect he had such a terrible heart problem. Just wanted to add that.

Why are these arteries already occluded? 15 months is hardly anytime at all. I just don't understand this. Please advise asap since he was just admitted tonight.

I am worried sick.
doctor
Answered by Dr. Sapan J. Pandya (22 minutes later)
Hi,

Thanks for your query.

A properly done Triple Bypass where arteries are used, may last for 12-15 years. If veins are used, 5-6 years. In his case I do not know what vessels were used.Redo Bypass is more difficult for operating surgeon, but do not worry. Nowadays Redo Bypass is also done very well as its common these days.

Sometimes Bypass grafts can fail soon after surgery due to technical problems with the grafts' insertions into the native coronary arteries or thrombosis of the grafts.

Before he was admitted for redo bypass surgery, the options to relieve your boy friend's current chest pain included:
(1) Increased doses of anti-anginal medications (nitroglycerin, beta blockers, etc.), Increasing anti-anginal medications often helps to relieve angina. It would have been tried by his cardiologist.
(2) Angioplasty. Angioplasty of the native arteries may be an option depending on many technical features, but this depends on the severity of the blockages in his native arteries. He had two angioplasties done but both failed.
(3) Redo bypass surgery. Redo bypass surgery would be difficult, given that he has already had an open heart surgery.

If none of these options work for your boy friend, then he could be considered for new therapies that are currently being investigated like laser revascularization procedures and growth factors that stimulate the growth of new blood vessels to the ischemic areas of the heart muscle.

His BMI is 26.4, so slightly overweight. May he has dyslipidemia, that is problem of Lipids, which lead to Coronary Artery Disease even in non-obese individuals.

I hope you find this information useful. Only his cardiologist can provide specific diagnoses and therapies. Please feel free to write back with additional questions.

Best of luck.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sapan J. Pandya (3 hours later)
You said that Redo Bypass surgery would be very difficult, but that is exactly what they will be doing. I am extremely concerned, as he is regarded as a very high-risk cardio patient. He was trying to buy time, by getting the angioplasty(s) done so he could come to Chicago in a few days, but he literally has run down the clock here, and his surgeon finally convinced him to quit being stubborn and have the surgery now...before it is too late. I guess I am wondering what the statistics ay about someone who is facing a 2nd triple bypass (same three coronary arteries) within 15 months of the last one. I can't help but feel panicked by this and would like to know what his chances of survival are, just off of past data. Again, he really is not obese, nor does he have any other ongoing conditions such as diabetes, that could cause other complications.
doctor
Answered by Dr. Sapan J. Pandya (1 hour later)
Hi again,

As I had suggested you before to stay clam and not to panic, I would advise you the same again. He is in safe hands. The redo bypass surgery is difficult to perform technically and not more risky than first bypass surgery. But now a days are performed as frequently as a Bypass surgery and also with good results.

As for data and percentage (statistics), they vary from institute to institute and from surgeon to surgeon. So, it would be better to not to worry about the statistics and discuss with the treating Doctor about the risks.

Please do not worry and trust your Doctor.

Hope this answers your query.
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. Chakravarthy Mazumdar
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Answered by
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Dr. Sapan J. Pandya

General & Family Physician

Practicing since :2011

Answered : 243 Questions

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Is It Possible That Somebody Has To Undergo Same Three Arteries Bypassed Within 15 Months ?

Oh...not really a question, but my boyfriend is in great shape in terms of wieght proportionate to his height. He is 6'1", 200 lbs. He doesn't have an ounce of fat on him, no beer belly.....has always worked out and has been in great physical shape. From the outside, you would never suspect he had such a terrible heart problem. Just wanted to add that.

Why are these arteries already occluded? 15 months is hardly anytime at all. I just don't understand this. Please advise asap since he was just admitted tonight.

I am worried sick.