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Blocked bypass grafts: Anyone faced a complex PCI decision?
1m and 80 y/o male who had 4 by-pass sugery 20 years ago. A recent catherization revealed that 3 of the 4 are blocked and calcified. Options presented are increase statins + add 60 mg of isosorbide mononitrate and wait to see if there is any softening in the blocked areas. Or, perform a procedure called a cross-over (A.K.A. the widow maker). Due to my small vessels, there is additional concern. I question whether the use of a IVL (INTERVASCULAR LITHOTRIPSY) could be considered on the existing blockage with surgery to follow to place stints. Anyone experience any like this.
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Hi @meatheads. It sounds like you’ve been given a lot of information and are weighing some difficult decisions after your bypass surgery served you well for 20 years.
It also sounds like you’re hoping to hear from others who have faced a similar situation. I’m wondering, are you having symptoms like chest pain or shortness of breath that led to the catheterization, or was this found during routine follow-up? I am tagging @moey2720 who mentioned having an Angiogram-Complex PCI with lithotripsy.
I’m also curious what your cardiologist sees as the main goal right now. Is it to manage your symptoms with medication if possible, or do they feel the procedure will likely become necessary?
I hope members who have faced blocked bypass grafts or had to decide whether to undergo another coronary procedure years after bypass surgery will share what that experience was like.
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1 Reaction!harsh
You pretty much nailed the symptoms and though they weren't knock you issues thwe consistant funny thing about my doc. He is very much shy to tell you what may be wrong he is very conservative. I had to request a post op meeting to get the information from the cardiologist wanting to know what is best. He, true to form, wants to treat with meds and light exercise. His goal is to make to make me comfortable and observe. We aren't in the boonies, but there is not enough of
the right equipment and backup people
I'm 75 now. I had triple by-pass 8 years ago and my cardiologist (Kaiser Medicare) one graft collapsed 6 years ago (3 days after Covid vax) said tuff luck and refused to do anything . Now I am told a second one has done the same. Arteries are too small to stent they say. More meds prescribed, but no other actions to be taken. I read a Mayo Clinic paper that said to re-due the by-pass, but I cannot get my doctors to agree. I don't want to give up at this point, but need better direction to get the doctors to take action.
Last BP: 109/70 (July 13, 12PM) Total Cholesterol 94 previous 91 (May 2026)
@hotrodbob0u1
Sorry to hear your going through all this crap. I'm 80 and the decision is not just that of the doctor. These decisions, in my opinion, are personal. Get a different cardo doc, or atleast an opinion. There is tons of stuff on line, right or wrong it is something to think about. Ofcourse I want to see 90, but if it means sitting in a rocker, doing crossword puzzles and watching reruns of Green Acres, I ain't so sure I might decide the risk is worth it.