70% blockage

[aussie girl]

hi everyone, I have moderate to severe aortic stenosis which will probably be operated on later this year. Yesterday I had an angiogram just to make sure there were no nasty surprises when they operate but unfortunatly they found 2 of my arteries are blocked one at 70% . I have done heaps of reseach on valves but know very little about bypass surgery. How bad is this blockage?.Will this make my doctor tell me I have to have surgery straight away? Help please Thankyou ....Mary

 

[hensylee]

Hi Mary, I had quad bypass 3/2000. Mine were 95% blocked and I had a heart attack. The surgical going in and coming out are exactly the same as the going in and out for valve surgery. I have the same scar. Recovery time and activity are the same. The one difference is that you will have some new meds, probably and will have to learn to read labels when you grocery shop. Your cholesterol will have to be watched carefully. In hospital they will probably give you lots of information to teach you how. You will need to begin exercises. You may be put on a statin drug to lower your cholesterol. Listen to your muscles, especially the leg muscles and if you have weakness or pain, you will want to notify your doctor and ask for a change to another as, in some people, statins can do much damage (it did that to me). I finally refused to take any more statins so my dr put me on zetia and it is doing a good job. Statins don't harm most people. If you are on a cholesterol lowering drug you will have to get a lipids blood test every six months to be sure your liver and cholesterol (a few other things too) are ok and within proper limits.. I expect the dr will bypass the ones he finds that are blocked while he works on your valve. Some valvers in VR have had both done at the same time and might stop here to give their experience. Blessins............

 

[tprice54]

bypass

bypass

I had one bypass with my AVR, done at the same time. They will most likely do both for you at the same time. They found one of mine blocked 50% at the heart cath the day before surgery, so fixed it while I was wide open. It's best to have all the parts fixed while you are in the shop!

 

[ALCapshaw2]

Welcome to my world Mary (i.e. CAD plus Valve issues)

It would help to know WHICH arteries are blocked. Generally, 70% is NOT considered severe. Years ago I was told that for most arteries, ANGIOPLASTY was the preferred treatment (which can be performed in the Cath Lab) for blockages of 70 to 90%. Over 90%, ByPass surgery is usually recommended.

After my ByPass Surgery, the use of STENTS to help keep arteries open became popular. Now they are finding that Stents sometimes CAUSE blockages to develop. There are different types of stents (medicated and not medicated) etc and I am not up to date on how these affect future clotting risks. Ask your Cardiologist and / or Surgeon.

The primary exception to the above if if the blockage is in the Left Main Artery. If that artery closes off, it's 'Adios Amigos' and therefore Bypass Surgery is recommended at lower levels (often 70%).

Going in for Valve Surgery may change the 'trigger points' since they would prefer to do BOTH Bypass and Valve surgery at the Same Time rather than separately.

Hope this helps.

'AL Capshaw'

 

[Praline]

When I had my OHS, the angiogram found a 80% blockage in the main artery to my heart. The surgeon was more concern with the blockage than the MV regurgitation when it came to timing the surgery. He said that with just the MV regurgitation, without the blockage, he would have been willing to wait longer to do surgery. I had a MVRepair and a bypass.

 

[67walkon]

Good questions! Checking your coronary arteries seems to be SOP when they are getting ready to do valve replacement. The bypass surgery is pretty routine stuff, apparently, when they have your chest open anyway.

I'm having valve replacement surgery in about a month. They want me to have a catherization to see how the arteries are, and while I expect them to be fine, it doesn't hurt to check!

You're getting 2 for 1, look at it that way!

John

 

[aussie girl]

Thanks guys, I didn't ask which arteries were blocked because I didn't know enough about it and also I think I was a bit shocked bescause I wasn't expecting it. My main problem is I'm hoping to be able to get an on-x valve but that might take some time finding a surgeon who is experienced with these and if the bypass is deemed an emergency I might not have the time and have to settle for the St Judes.....Mary

 

[aussigal]

You have already got some great answers. I just wanted to add that you are definately not alone with this. I had a partially blocked artery that ended up getting a by-pass when my heart wasnt pumping well after my AVR. Its much better and easier to get this done at the same time and as a planned event during your surgery.

The extra OP shouldnt make any difference to your recovery if you have no other complications except for maybe an extra scar depending on where they harvest the vein from. Mine came from my lower leg and gave me no trouble or pain.

They probably have you on Cholesterol pills now in an effort to try limit further blockages. If not I would be inclined to ask about them and if they would help.

 

[Kathleen]

Mary, You won't be settling by getting a St Judes valve, you will be getting the gold standard solution to your problem. When you find out which artery is blocked the doctors should be able to tell you what they consider to be the best option for fixing both issues. I have the medicated stents and want to mention if you chose that route the Plavix you will have to take for the rest of your life may not sit well with coumadin. Do some research or give me a holler if they want to stent rather than bypass.
Kathleen

 

[aussie girl]

Sorry Kathleen, I didn't mean to sound like I thought the St Judes is no good or second best. I know that if I do get a St Judes my heart will be in good hands. It's just that after doing lots of reading I decided the on-x would be good for me and I'd be a little disappointed if I can't get it. If the doctors decide a stent is the way to go for the blockage I would certainly appreciate your help with the medicines. Thanks Mary

 

[tprice54]

Just a quick note....my one bypass artery was harvested from my breast muscle. This meant no extra incision or healing...also studies show this artery never placques up (so I'm told).

 

[Jkm7]

I was also told the mammary artery rarely closes and bypasses using it are good for very much longer than for instance the sapphenous vein from the leg.

I had double bypass and one was mammary artery and one from my leg.

 

[ALCapshaw2]

Thanks guys, I didn't ask which arteries were blocked because I didn't know enough about it and also I think I was a bit shocked bescause I wasn't expecting it. My main problem is I'm hoping to be able to get an on-x valve but that might take some time finding a surgeon who is experienced with these and if the bypass is deemed an emergency I might not have the time and have to settle for the St Judes.....Mary

Mary,

I took the liberty of e-mailing this post to Catheran Burnett who is the Information and Promotion Manager for MCRI, manufacturer of the On-X valves.

She asked me to suggest that you e-mail her at [email protected] She informed me that there are several On-X Valve recipients in Australia and she would be glad to put you in contact with their Australian Sales Representative who should be able to provide you with the names of surgeons that use the On-X valves.

Best Wishes,

'AL Capshaw'

 

[TrophyWife]

Hi!
I just had a triple along with a St. Jude's Atrial --95% blocked and a rock hard valve. Not on my agenda - and I certainly didn't know what hit me!
I too wanted the On-X - but am reasonably sure that we did the right thing with the St. J.

Two words of whatever ------
1. If it were me, I wouldn't want my heart repair in the hands of a salesman. As a previous drug rep - I speak from experience. And
2. Sit-ups. Start now. Crunches, sit-ups ------ whatever you call them. Your abs will do all the work when you're recouperating, so get 'em in shape now!!

 

[aussie girl]

I have been in contact with Catheran Burnett in Texas and also the Australian rep and he gave me the name of a surgeon in the area I live in. This doctor is the director of cardiothoracic surgery in the main hospital in my state and has also worked for some of the leading hospitals in the country so i'm feeling very positive about the outcome. I see my cardio on the 12th june and we go on from there ....Mary