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Dr. Andrew Rynne

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Undergone angioplasty and had bypass surgery. Blockage reformed. Way to treat?

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Dr. Anantharamakrishnan

Cardiologist

Practicing since :1966

Answered : 4506 Questions

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Posted on Tue, 29 Jan 2013 in Hypertension and Heart Disease
Question: Hello Sir,

My father 56 years of age, had undergone angioplasty once in 2009 for LAD with 95% blockage and restenosis happened again. Went for Bypass surgery in 2010 and its good till now. Recently in May 2012, he was diagonised with LCX and OM occlusions and has undergone angioplasty with bifurcation medicated stents. Within 2 months blockages are reformed with total occlusion in OM1 and sub-total in LCX again. DO you suggest to go for angioplasty again or is there a way to treat it differently?
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Answered by Dr. Anantharamakrishnan 28 minutes later
Dear XXXXXXX
Welcome to Health Care Magic

The obstruction is mechanical and the only way to treat is by mechanical relief.
If feasible, angioplasty must be done.
If not feasible, he needs bypass surgery again.
Earlier, the better.
There is no other option.

Strict control of Diabetes / cholesterol is in need.
Discuss with your cardiologist for further investigation of less common causes of obstruction, that may be contributing

Take care
Wishing speedy recovery
God bless
Good luck

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Anantharamakrishnan 2 days later
Hello Sir,

Thanks for the reply. He is maintaining his diabetes well and Cholesterol is very much under control. Is there is a way to identify the root cause for his blocking? How risky is doing bypass surgery for the second time? Will putting stent inside stents increase the risk of re blocks again?

Thanks,
XXXXXXX
doctor
Answered by Dr. Anantharamakrishnan 3 hours later
Hi,

Diabetes itself is a risk factor and contributes greatly..
Cholesterol, smoking, obesity, blood pressure, sedentary life, stress and so on are all well established and modifiable risk factors.
There are a few less common causes like homo-cysteine, clotting factors etc.

The risk of bypass is slightly more than usual – in diabetes and second time – but not very high.

Stents can be put safely again at the place, in case of need – there are several instances on the same sitting or very early in some cases.

Failure to intervene may well be a greater risk, in such situation.

All the best

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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