When is by-pass surgery necessary over a stent in the LAD?

Posted by normanturner525 @normanturner525, May 21 7:06am

A heart cath indicated that I had a 50%-60% blockage in the LAD artery. The cardiologist recommended a stent. A second opinion indicated by-pass surgery over the stent. Which is the most acceptable at this point?

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If you don't have any symptoms - you don't need a stent. Only if you are having symptoms. Invasive procedures such as bypass surgery and stenting—commonly used to treat blocked arteries—are no better at reducing the risk for heart attack and death in patients with stable ischemic heart disease than medication and lifestyle changes alone.
Angioplasty Heart Stent Risks vs. Benefits - https://www.youtube.com/watch?v=uYiD2lhtsV4

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@brique

Hi @jlharsh - yes, we have the uncommon in common for sure with the LMCA blockage. It's a prize nobody want's to win! Matter of fact, if I didn't have that LMCA involvement at just over 50% my treatment plan would have likely been a stent in my RCA during the cath, and medications alone with regular watching for future blockage in my LAD - but since there is a need to CABG bypass the LMCA the Interventional Cardiologist left things alone so as to not complicate CABG surgery, and leave the RCA and LAD for bypass at the same time.

Yes, the Interventionist who did my cardiac catheter angiogram is at Mayo in Rochester, and the Interventionist I am meeting with on Monday is too. I have had Mayo as my primary care provider in a satellite clinic since 2022, so I didn't require a referral for care. As far as the hospital stay for my surgery, barring any complications or longer recovery needs (knock on wood), it was relayed to me it's a couple days in ICU post-surgery, then 5-7 days in the hospital itself.

I can relate with @normanturner525 on the need/want to get some things done beforehand. It's tough electing for a procedure that is more prophylactic than relieving symptoms, but with the information that so much risk is at play should an adverse event occur, you feel like you're left with no choice. It's a rock and a hard place for sure.

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I hope your surgery goes well tomorrow, @brique.

Please come back and give us an update as soon as are up to it.

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