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Failed/Missing Graft after bypass
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An_254656 posted:
Hi

Please can someone help? My 66 year old mother had a double bypass a year ago. She has never been well since. She has had an angiogram and it showed one if her grafts has gone missing. She has subsequently had a cat scan to see if they can find it and we are awaiting the results. I want to find out how serious this is and if anyone has had this happened to them before?

Thanks in advance.
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cardiostarusa1 responded:
Hi:

......"and it showed one if her grafts has gone missing."

As applicable, sounds like the vein graft had closed up/shut down and shriveled up.

Clinical studies (some large-scale) have shown that, depending on the type of graft used, the individual himself or herself/individualized factors, bypass grafts may/can last from 10-15 years or longer.

However, in some instances, grafts may/can fail early/prematurely (e.g., 1, 2 or 3 years) or even fail right after or shortly after the surgical procedure is completed.

Common venous grafts are the greater saphenous veins (GSVs) in the leg(s), which are accustomed to low pressure. Common arterial (accustomed to high pressure and are more resistant to atherosclerosis) grafts are internal mammary or thoracic arteries (in the chest, most common is the left as opposed to the right, sometimes both can be used) and radial arteries (in the arm). Uncommon graft conduits include the right gastroepiploic artery, the inferior epigastric artery and the subscapular artery.

Saphenous vein graft (SVG) failure after bypass surgery may be a high as 5%-10% in the first post-operative week. Disruption of graft endothelium correlates with early graft failure. The cardiothoracic surgeon should take measures during the surgery to avoid endothelial injury to the vein graft.

"I want to find out how serious this is"

Symptoms of a failed or collapsed bypass graft, include that of a blocked native coronary artery, which can include (when there is no, or insufficient collaterals, backup or rescue vessels) heart attack (myocardial infarction, MI, actual death or necrosis of heart muscle), which in turn can gradually, or quickly/suddenly (acutely) lead to heart failure/congestive heart failure, and sometimes sudden cardiac death (SCD).

The bottom line

Coronary artery bypass graft (CABG) surgery is just a clever way of temporarily circumventing the problem (atherosclerosis), as it doesn't address the disease process and what drives the progression.

Coronary artery disease (CAD) is a lifelong unpredictable (may/can exhibit periods of stabilization, acceleration and even some regression) condition requiring a continuum of care.

Best of luck to your mother.

Take care,

CardioStar*

WebMD member (since 8/99)



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Be well-informed


HeartSite

Coronary artery anatomy

Starting with the left anterior descending (LAD), the most critical, next to the ultra-critical left main (LM).

http://www.heartsite.com/html/lad.html

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WebMD

Living with Heart Disease

Coronary artery disease (CAD)

CAD is a chronic disease with no cure. When you have CAD, it is important to take care.....

This is especially true if you have had an interventional procedure or surgery to improve blood flow to the heart../It is up to you to take steps.....

Recognize the symptoms......

Reduce your risk factors......

Take your medications......

See your doctor for regular check-ups...
...

http://www.webmd.com/heart-disease/guide/living-with-heart-disease

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Good to know, for the primary/secondary prevention of heart attack/brain attack

Epidemiologic studies have revealed risk factors (encompasses new, novel or emerging) for atherosclerosis, typically affecting the carotid, coronary, peripheral arteries, which includes age, gender, genetics, diabetes (considered as being the highest risk factor), smoking (includes second/thirdhand), inactivity, obesity (a global epidemic, "globesity"), high blood pressure (hypertension), Low HDL (now questionable, according to recent studies) high LDL, small, dense LDL, RLP (remnant lipoprotein), high Lp(a), high ApoB, high Lp-PLA2, high triglycerides, HDL2b, high homocysteine (now questionable), and high C-reactive protein (CRP/hs-CRP).

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WebMD/WebMD forums does not provide medical advice, diagnosis or treatment.


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