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What Does This Angiography Report Indicate?
Question: Hi before 1 month doctor did angiography of my father.Report is below
Left main coronary artery:-Distal 20% plaque.
left anterior descending artery :-osteo proximal 90% disease,D2 80% disease(moderate size vessel)
left circumflex artery :-OM1 80% disease OM2 90% disease
Right coronary artery :-proximal 90% disease,distal 100% occlusion of second PDA after origin of first PDA(second PDA filling retrogradely from LAD).
as par above report is my father ideal for bypass? his age is 61 years old.normal diabetic .
No any symptoms angina no any pain.2d eco report normal.lipid profile also normal.
Please guide me what to do?
Left main coronary artery:-Distal 20% plaque.
left anterior descending artery :-osteo proximal 90% disease,D2 80% disease(moderate size vessel)
left circumflex artery :-OM1 80% disease OM2 90% disease
Right coronary artery :-proximal 90% disease,distal 100% occlusion of second PDA after origin of first PDA(second PDA filling retrogradely from LAD).
as par above report is my father ideal for bypass? his age is 61 years old.normal diabetic .
No any symptoms angina no any pain.2d eco report normal.lipid profile also normal.
Please guide me what to do?
Brief Answer:
Yes, He is ideally suited for bypass surgery
Detailed Answer:
Hi XXXXXXX
I have gone through the report sent by you. Your father has severe triple vessel disease most probably because of Long standing diabetes. Just based on this report I can say that Yes, your dad is ideal candidate for bypass surgery and all present guidelines say the same.
If echo and everything is normal, it is good that he hasn't had any heart attack previously and so surgery will give great results. Also I assure you that in good hands it is a perfectly safe procedure
Do try convince your surgeon that he uses arterial grafts left-right internal mammary artery and if needed radial graft.
Y bypass? As he will require Multiple grafts bypass is safer and better long term results as compared to mutlivessel angioplasty which would be a complex procedure and less durable as compared to bypass.
If you can send the Cd I will be into a better position to advice you for the same.
You can get a thallium perfusion scan. If it is normal than you may manage him on medicine,
Regards. Dr Priyank mody,
Lilavati Hospital, XXXXXXX
Yes, He is ideally suited for bypass surgery
Detailed Answer:
Hi XXXXXXX
I have gone through the report sent by you. Your father has severe triple vessel disease most probably because of Long standing diabetes. Just based on this report I can say that Yes, your dad is ideal candidate for bypass surgery and all present guidelines say the same.
If echo and everything is normal, it is good that he hasn't had any heart attack previously and so surgery will give great results. Also I assure you that in good hands it is a perfectly safe procedure
Do try convince your surgeon that he uses arterial grafts left-right internal mammary artery and if needed radial graft.
Y bypass? As he will require Multiple grafts bypass is safer and better long term results as compared to mutlivessel angioplasty which would be a complex procedure and less durable as compared to bypass.
If you can send the Cd I will be into a better position to advice you for the same.
You can get a thallium perfusion scan. If it is normal than you may manage him on medicine,
Regards. Dr Priyank mody,
Lilavati Hospital, XXXXXXX
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Thanx very sir
my father is ready to bypass.we are thinking to bypass after 15-07-2015.
any why thallium perfusion scan? please explain
and before bypass i want CT angiography of my father.
because he is thinking first do it than we will go ahead with bypass.
any some dr said me you dont have time do fast bypass so i m very much afraid now n days.
is it ok if i do bypass after this 10 days?
my father is ready to bypass.we are thinking to bypass after 15-07-2015.
any why thallium perfusion scan? please explain
and before bypass i want CT angiography of my father.
because he is thinking first do it than we will go ahead with bypass.
any some dr said me you dont have time do fast bypass so i m very much afraid now n days.
is it ok if i do bypass after this 10 days?
Brief Answer:
No problem in waiting for 10 days, no CT angiography needed
Detailed Answer:
Hi XXXXXXX
Important points to note
1) angiography and CT coronary angiography is same, rather the conventional is better, so if it's done you don't need CT angiography at all. Don't expose your father to unnecessary radiation. Do consult your doctor once.
2) the blockages of your father seem not acute and so waiting for 15 day s will not be a problem, however do continue meds including blood thinner till 5 days before surgery. So don't worry in that context
3) many a times in chronic blockages, there is development of collateral, that's natural God way of doing bypass, so in spite of disease there is enough blood supply to the heart. With such severe disease, chances are less, but if normal stress perfusion scan, than no bypass is needed and it will be of no help. So only medication is enough. You may take that chance as there is no much radiation and it's non Invasive
Take care and let me know if any help needed
Regards
No problem in waiting for 10 days, no CT angiography needed
Detailed Answer:
Hi XXXXXXX
Important points to note
1) angiography and CT coronary angiography is same, rather the conventional is better, so if it's done you don't need CT angiography at all. Don't expose your father to unnecessary radiation. Do consult your doctor once.
2) the blockages of your father seem not acute and so waiting for 15 day s will not be a problem, however do continue meds including blood thinner till 5 days before surgery. So don't worry in that context
3) many a times in chronic blockages, there is development of collateral, that's natural God way of doing bypass, so in spite of disease there is enough blood supply to the heart. With such severe disease, chances are less, but if normal stress perfusion scan, than no bypass is needed and it will be of no help. So only medication is enough. You may take that chance as there is no much radiation and it's non Invasive
Take care and let me know if any help needed
Regards
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thanx Sir G
You make me very relax.God bless you.
So if do this perfusion scan test and if it is normal than no need for bypass?
Sure i will convince my father for this test.
And my father is forcing me to to CT angio because he is thinkin that my blockages are become less due to yoga and some ayurvedic medition so he wants to check again blockages and wants to decide bypass after this ct angio.
however he dont know blockages can reduce by ayurvedic medition.
any ways i will do perfusion test.AND is EECP or ACT THERAPY WILL HELP ?
You make me very relax.God bless you.
So if do this perfusion scan test and if it is normal than no need for bypass?
Sure i will convince my father for this test.
And my father is forcing me to to CT angio because he is thinkin that my blockages are become less due to yoga and some ayurvedic medition so he wants to check again blockages and wants to decide bypass after this ct angio.
however he dont know blockages can reduce by ayurvedic medition.
any ways i will do perfusion test.AND is EECP or ACT THERAPY WILL HELP ?
Brief Answer:
All the best for surgery and. EECP / other - No
Detailed Answer:
Hello XXXXXXX , I do understand that as a son how difficult it is to explain things to your father, but as a doctor I cannot recommend you the same, because it would be unethical for me to say so however if you decide to do it get it done in more advanced machine 256-320 slice preferable or minimum 64 slice to minimise the dose of radiation.
Now why even stress perfusion? The blockage you said is visual as your cardiologist will see 90% I may think it is 80%, so if it's borderline disease and long standing enough collateral are developed. Other other ways are so tress dobutamine echo or cardiac MRI, but the best and most suitable in the case of your father might be perfusion scan and because we wanted to be sure that the bypass we are doing is 100% needed..
EECP and other are for refractory heart failure. It means in whom in spite of all medical heart pumping is very low, even in such condition there are no favourable results, rather it may harm like in chelation therapy they kidney may be damaged. So for your father who has normal 2d echo, such therapy is strict NO from my side
All the best for surgery .
Let me know if any help is needed in future
Regards Dr. Priyank Mody
All the best for surgery and. EECP / other - No
Detailed Answer:
Hello XXXXXXX , I do understand that as a son how difficult it is to explain things to your father, but as a doctor I cannot recommend you the same, because it would be unethical for me to say so however if you decide to do it get it done in more advanced machine 256-320 slice preferable or minimum 64 slice to minimise the dose of radiation.
Now why even stress perfusion? The blockage you said is visual as your cardiologist will see 90% I may think it is 80%, so if it's borderline disease and long standing enough collateral are developed. Other other ways are so tress dobutamine echo or cardiac MRI, but the best and most suitable in the case of your father might be perfusion scan and because we wanted to be sure that the bypass we are doing is 100% needed..
EECP and other are for refractory heart failure. It means in whom in spite of all medical heart pumping is very low, even in such condition there are no favourable results, rather it may harm like in chelation therapy they kidney may be damaged. So for your father who has normal 2d echo, such therapy is strict NO from my side
All the best for surgery .
Let me know if any help is needed in future
Regards Dr. Priyank Mody
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanx sir.
i will not do CT angiography.i will first do thaliam test.than i will go ahead with bypass.
Thanx very much sir G.once i have test result of thalium i will forward to you.
can i have your personal email or cantact details if you dont mind?
i will not do CT angiography.i will first do thaliam test.than i will go ahead with bypass.
Thanx very much sir G.once i have test result of thalium i will forward to you.
can i have your personal email or cantact details if you dont mind?
Brief Answer:
Thank you for appreciation :)
Detailed Answer:
I am happy I could help.
Sure you can forward the report when done through a direct query .
Regards and wishing well for your father.
Dr. Priyank Mody
Lilavati Hospital, XXXXXXX
Mb) 0000
YYYY@YYYY
Thank you for appreciation :)
Detailed Answer:
I am happy I could help.
Sure you can forward the report when done through a direct query .
Regards and wishing well for your father.
Dr. Priyank Mody
Lilavati Hospital, XXXXXXX
Mb) 0000
YYYY@YYYY
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Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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