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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

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Do I Need A Bypass Surgery If Suffered From A Minor Heart Attack?

Hallo sir, my name is Arpita Saha, am from kolkata I want to tell u about my father Anil Saha 56+ he has got an minor attack in Nov'10. He is also a B.P & Diabetic patient frm last 6yrs,his wght is 67kilo.Hear doctrs has suggested for bypas surgery but aftr a few month they adviced to contiue Medicins.i want to consult about my fathr wid Dr. Devi Shetty a cardio specialist,plz sir advice me for a bettr treatment for my Paa.

0000
Fri, 23 Oct 2015
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Cardiologist 's  Response
Hello. Welcome to HCM and thank you for your question. I carefully read your query.

Due to not sufficient information provided, I will do my best in addressing your concern. If there was a discussion about stent implantation (not bypass surgery) then the recommendation offered to you by the doctor, probably was about the culprit artery of the heart attack to be ballooned (angioplasty) and stented. If a certain time passes from the moment of onset of chest pain (e.g. 6 or, maximum, 12 hours), it is estimated that a stented artery achieves very little benefits from reopening the total blockage. If this is the case, then a certain time had passed, and, since it was only a minor heart attack and did not severely impact the cardiac function, then further, proper, regular medical treatment was recommended.

On the other side, if the doctors suggested bypass surgery (CABG - coronary artery bypass grafting), then this recommendation was not because of the heart attack, but because he probably has the three coronary vessels diseased and narrowed by atherosclerotic plaques. In this case, depending on the quantitative study of these blockages, we recommend the patient to undergo angioplasty + stent, or CABG. Always, after carefully measuring the risk/benefit ratio. If this is the case, and yet doctors recommended that he should continue on regular medical treatment, my opinion is that the perioperative risk for CABG was high, and the best recommendation, again, after carefully measuring the risk/benefit ratio, was to continue on regular medication.

I hope this answers your question. Best regards.

Dr. Meriton
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Cardiologist Dr. Rajesh Teli's  Response
hello,
I have gone through your query.Thanks for using HCM.
After having one heart attack one needs to undergo coronary angiography.One can decide about need for bypass only after getting report of angiography.Diabetic patients usually significant blocks in all 3 vessels supplying blood to heart.So one can presume that there may be need for bypass.I suggest you to get his angiography done,after we can decide whether he needs it or not?,
My best wishes
Dr.Rajesh Teli,MD.
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Do I Need A Bypass Surgery If Suffered From A Minor Heart Attack?

Hello. Welcome to HCM and thank you for your question. I carefully read your query. Due to not sufficient information provided, I will do my best in addressing your concern. If there was a discussion about stent implantation (not bypass surgery) then the recommendation offered to you by the doctor, probably was about the culprit artery of the heart attack to be ballooned (angioplasty) and stented. If a certain time passes from the moment of onset of chest pain (e.g. 6 or, maximum, 12 hours), it is estimated that a stented artery achieves very little benefits from reopening the total blockage. If this is the case, then a certain time had passed, and, since it was only a minor heart attack and did not severely impact the cardiac function, then further, proper, regular medical treatment was recommended. On the other side, if the doctors suggested bypass surgery (CABG - coronary artery bypass grafting), then this recommendation was not because of the heart attack, but because he probably has the three coronary vessels diseased and narrowed by atherosclerotic plaques. In this case, depending on the quantitative study of these blockages, we recommend the patient to undergo angioplasty + stent, or CABG. Always, after carefully measuring the risk/benefit ratio. If this is the case, and yet doctors recommended that he should continue on regular medical treatment, my opinion is that the perioperative risk for CABG was high, and the best recommendation, again, after carefully measuring the risk/benefit ratio, was to continue on regular medication. I hope this answers your question. Best regards. Dr. Meriton