Hello! Thank you for asking on HCM! I understand you concern, and would like to explain that when judging the need for a new revcascularisation procedure, a comprehensive guide on decision making would be the recent clinical symptomatology (is there evidence of ischemic angina or its equivalents, etc), coupled with some functional and some imagine tests. Besides coronary angiography which is the standart for making evidence of coronary artery lesions, other tests like traditional exercise stress test, or any available myocardial perfusion imagine test (like for example Cardiolite, etc), may be helpful to identify the pissible ischemic consequences of any new coronary stenoses (confirmed on coronary angiography). If new coronary stenoses are present (on coronary angiography), and no collateral circulation is compensating blood supply deficits, coupled wit hclear evidence of myocardial ischemia (on perfusional imagine tests), then a revascularisation procedure should be consider. Probably facing your prior medical history, the best revascularisation option to be followed would be a percutaneous coronary angioplasty with eventually stent implantation. Nevertheless, the latter discussion is almost thoroughly a technical one, and depends also by thechnical skills of the medical team, as well as by available techniques at the attending medical center. You should discuss with your attending cardiologist about the above mentioned issues. Hope to haave been helpful to you. Greetings! Dr. Iliri