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Open heart surgery
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Evelyn9719 posted:

Is open heart surgery a good option for a 55 yrs old if the left main artery is blocked 70% and other two arteries blocked 60% and 50% ?
Also what is the life expectancy after the surgery is performed?
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billh99 responded:
It was for me at age 66. 70% in the LM and 70 is an other artery.

And a year latter I was diagnosed with prostate cancer. Because it is slow growing the recommendation is not have surgery if other conditions would limit your life to less than 10-15 years.

Of course my cardiologist would not/could not be specific when I asked him if I should consider surgery. He said "I expect your to have a long and healthy life".

Now I have no idea of what your health and lifestyle is like otherwise.

But I was in fair shape before and have worked to maintain and improve my lifestyle. Today I did a 35 mile bike ride.
 
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cardiostarusa1 responded:
Hi:

Life expectancy is highly-variable, as one has to take into consideration various factors and conditions, such as possible complications (some unforeseen) and the progression of the disease, which can sometimes be accelerated.

"Is open heart surgery a good option for......"

Well it certainly may/can be for left main stenosis of 50% or greater, though with other coronary arteries, such as the right coronary artery, left anterior, or left circumflex, doctors typically consider/may perform bypass (or angioplasty with or without stents) on blockages that are 70%/75% or greater. Sometimes, customized drug-therapy is the chosen course of treatment for the patient initially.

About the Left Main (LM)

Noteworthy, an absolute worst case scenario would be a total (100%) occlusion/blockage, as the LM feeds a massive left ventricular area, and while extremely rare, is almost always invariably fatal.

The LM arises from the aorta (the largest artery in the human body), typically 1 to 25 mm in length, with the diameter of a straw, and then splits (bifurcates) into the left anterior descending (LAD) and the left circumflex (LCX).

There is also coronary artery dominance, e.g., right-dominant, left-dominant and co-dominant, something that is seldom talked about, discussed, though can be extremely important in certain cases (such as LM stenosis).

Dominance

Depending on which coronary artery (left or right) crosses the midline of the heart posteriorly (back wall) i.e., the crux, dominance is determined. In most individuals (approximately 85%), it is the right coronary artery.
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Look Back in the Media

WebMD

Angioplasty OK for Major Heart Artery

Study Shows Angioplasty May Offer Option to Open Blockages in Heart Artery That Supplies Most of Heart's Blood - April 1, 2008


Angioplasty may be a perfectly good option for opening up blockages in the major artery that provides most of the blood to the heart, South Korean researchers say.

They studied people with blockages in the left main coronary artery. It supplies blood to the left side of the heart muscle, which is the side that pumps fresh blood to the rest of the body. Current guidelines call for these patients to undergo bypass surgery.

http://www.webmd.com/heart-disease/news/20080401/angioplasty-ok-for-artery-clogs

SCAI

Experts Debate Stents vs. Bypass for Left Main Coronary Artery Disease - May 11, 2007

The Stakes Are High in Artery Supplying Blood to Two-Thirds of the Heart


(Excerpt)

Coronary artery bypass surgery has been the preferred treatment for patients with a blockage in the left main coronary artery, the conduit that supplies blood to about two-thirds of the heart.

HOWEVER, in recent years this has been challenged by stent placement in this critical artery. Trusting treatment of such a critical vessel to percutaneous coronary intervention (PCI) is anathema to some. To others, it is the reasonable next step, given recent advances in stent technology.
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Best of luck down the road of life.

Take care,

CardioStar*

WebMD member (since 8/99)



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