Treatment for Coronary Total Occlusion(100% blockage)

@caretakermom- Anna, Hello. Since my HA was the result of finding out about my occlusion the stent was placed here at our local hospital in the Willamette Valley of OR. Because of the damage to my heart I had issues with my EF (Ejection Fraction) and had both an Echo as well as a nuclear stress test a year afterwards that really didn't show any changes (collateral blood vessels developing).
I decided to go to the AZ. Mayo for a battery of tests which was led by a great cardiologist named Dr. Lynch. He was amazing!!
The day ended with a Stress Echo which provided the best info he felt for him to determine my actual EF.
Prior to that last Echo back in Corvallis I had gone back to my normal workout regime of 3x a week in an effort to boost my EF, but had been told after my 2nd Echo that there was no real change. After going through the tests at AZ. Mayo in consultation with Dr. Lynch he told me that he felt my EF was more closer to 45-47% rather than the 30% I was being told here. I have felt great after receiving the stent and a new lease on life, but the psychological feeling of what I called "damaged goods" weighed on me and I was determined to do all I could do to reverse that. My visit to the AZ. Mayo put me on that path and I hope you reach out to them.
Mayo provides superior care in so many ways that I will continue to go there for 2nd opinions if needed. For now I remain in great health and am Thankful!
Jim @thankful

@caretakermom- Anna, My EF improved, but not according to my cardiologist here where my stent was placed. A year later after I had another Echo I was told by the same cardiologist that there was still no change. That's when I decided to make my appt. at the AZ. Mayo. It was approx. 6 months later that I had my appt. with Dr. Lynch and after that battery of tests he confirmed to me that my EF was more like 45-47 rather than 30-32 that I was being told back home. I've read and been told that in many cases collateral blood vessels will often grow into those areas affected in the heart, but mine either took longer and because of the 100% blockage there was damaged heart tissue that would never receive regeneration.
An EF of 65 is totally normal. It would be interesting to know what your husbands was prior to the stent. Jim @thankful

@caretakermom- Anna, My EF improved, but not according to my cardiologist here where my stent was placed. A year later after I had another Echo I was told by the same cardiologist that there was still no change. That's when I decided to make my appt. at the AZ. Mayo. It was approx. 6 months later that I had my appt. with Dr. Lynch and after that battery of tests he confirmed to me that my EF was more like 45-47 rather than 30-32 that I was being told back home. I've read and been told that in many cases collateral blood vessels will often grow into those areas affected in the heart, but mine either took longer and because of the 100% blockage there was damaged heart tissue that would never receive regeneration.
An EF of 65 is totally normal. It would be interesting to know what your husbands was prior to the stent. Jim @thankful

@caretakermom- Anna, If I had the time and was aware of my problem I would have definitely gone to Mayo, but as I said I only found out after suffering my HA. The main reason for the trip to the Mayo as I said was to get an 2nd opinion because I kept being told that my EF had not improved.
I had my HA in May of 2014 and went to the Mayo in April of 2018. The battery of tests I had there confirmed to me that my EF was far better than I had been told here by my Cardiologist over a 4 year period. Jim@thankful

Jim @thankful. Mayo pre kidney transplant nurse called today. They have reviewed all of husband's cardio records for the past 6 months. They are telling us he needs to get the CTO fixed before he can be qualified for a kidney eval. The thing I'm worried about is cardiologist says the PCI (Percutaneous Coronary Intervention) procedure success rate is a mere 30%. PCI is preferable because it is the least invasive as opposed to open heart surgery which has a much higher success rate to fix the blockage. So conflicted as to what to do. Cardiologist doesn't feel we need to address the CTO at this moment and gives the impression that it's not worth it to try PCI because of low success rate, so just leave as is. On the other hand, it would be great if husband can get a new kidney so that he could live a somewhat normal life but in order to do that, he has to have open heart surgery!! It sounds like cardiologist is saying husband can live a good life without having to do anything about the CTO, because the collateral blood vessels have formed.
Jim, did you ever have to have open heart surgery? This sounds very scary to me!

Jim @thankful. Mayo pre kidney transplant nurse called today. They have reviewed all of husband's cardio records for the past 6 months. They are telling us he needs to get the CTO fixed before he can be qualified for a kidney eval. The thing I'm worried about is cardiologist says the PCI (Percutaneous Coronary Intervention) procedure success rate is a mere 30%. PCI is preferable because it is the least invasive as opposed to open heart surgery which has a much higher success rate to fix the blockage. So conflicted as to what to do. Cardiologist doesn't feel we need to address the CTO at this moment and gives the impression that it's not worth it to try PCI because of low success rate, so just leave as is. On the other hand, it would be great if husband can get a new kidney so that he could live a somewhat normal life but in order to do that, he has to have open heart surgery!! It sounds like cardiologist is saying husband can live a good life without having to do anything about the CTO, because the collateral blood vessels have formed.
Jim, did you ever have to have open heart surgery? This sounds very scary to me!

@caretakermom- I never had open heart surgery. I would absolutely trust the Mayo Team of Doctors. Can you talk with a Mayo Cardiologist about this? Jim@thankful

@thankful, I hope you had a great thanksgiving!! Here is the update. Husband's cardiologist will attempt to fix the CTO by installing a stent. As mentioned in my earlier comment, the success rate is a mere 30% and our cardiologist does not recommend a bypass because it would be "overkill". Naturally, Mayo Clinic kidney transplant wants all cardiovascular disease fixed before they would even consider the patient for a kidney evaluation. So as it stands now, we will have our cardiologist perform an angioplasty and see what happens. If he can clear the blockage then my husband is good to go for kidney transplant eval at Mayo Az. If not, we will seek a second opinion at Mayo Az. I have made a appointment for the third week of Feb 2021, to consult with a Mayo Cardiologist. I was told the consulting cardiologist is NOT the interventive cardiologist who will perform the procedure. Dr. John Lynch has been assigned to my husband. Is this the same Dr. Lynch that you saw?
We were also told that NO visitors are allowed in the hospital because of COVID. The patient has to be tested for COVID at Mayo and must arrive 2 days prior to appointment. The first 2 days will be testing for COVID and if negative, we can proceed with appointment. So that means I will not be able to go to the appointment with husband. I did, however, request the initial consultation be done by video. And I sure hope Dr. Lynch can schedule all tests on the same day so that we do not have to stay too long in Az. My husband still works full time and very difficult for him to take time off. Since his kidney failure in Nov 2018, he has had to take much time off for surgeries and various doctor appointments and he is running out of PTOs at work. Most of procedures and surgeries he has had in the past 2 years are all for transplant clearances and have burned thru his PTOs!! I very much hope that our UCLA cardiologist is successful in fixing the CTO. If not, then I sincerely hope that Mayo can help resolve the CTO without having to resort to doing a bypass, which our current cardiologist says he DOES NOT recommend bypass for this kind of blockage. Cardiologist says husband can live a long life without having to fix the CTO, because the collateral blood vessels are supplying adequate blood supply(EF is 65%)Would be interesting to hear what Mayo has to say, if we need to seek a second opinion.