Heart pain-found 3 blocks in angiography

[Samjayesh555]

My father had a pain in heart last night.after check up doctor said it doesn't seem to be major problem but they will do angiography test to find out
whether there is any major blocks..after angiography the result was ,there is a problem in 3 vessels.I want to know in this case whether angioplasty or bypass surgery is better.doc said they will try to do angioplasty in 1 St vessel if it is sucess they will do angioplasty in other 2 vessels .If angioplasty in first vessel  is a failure then they go for a immediate bypass surgery.. I don't know what to do ..will any please help..The result is as follows




LMCA: 5.5 mm vessel ,bifurcates into LAD & LCX.disease free

LAD: Ostio proximal LAD total occlusion .LAD is seen filling through hetero collaterals

LCX:non dominant ,4.0 mm,gives rise to OM1(3.0mm),OM2(2.6mm)& continues az terminal OM(2.5).proximal LCX has 20-30% disease .Distal LCX to terminal OM has 90% disease with TIMI flow distally


RCA: dominant ,4.0 mm vessel gives rise to SA nodal RV branch RPDA(2.5 mm)& RPLB (2.5 mm) .Mid RCA has tubular eccentric 90% disease.pre crux RCA has 30 % disease                                              

[Ger57]

It is often difficult to say what the best solution is (bypasses or stents).
A lot depends on the skill of the cardiologist.
A skillful placement of stents can be as durable as bypasses, while the recovery is much easier.

Therefore, trying to stent and in case of failure switch to bypass surgery sounds like a good plan to me.
The ostial proximal position in the LAD is often difficult to stent. I think that is the position the will first try to open.
If that is a success, the other two seem easier to me.

[Al Dente]

These are difficult questions to post to cardiac forum that seems to have very little professional caridiology/vascular surgery input.  The posters here are patients, that themselves have gone through very difficult times, for some, and have had to balance healthcare very difficulty.  If I were you, with your father present and the cardiologists I would ask how effaceable stents are given his age?  I would ask if he has or develops diabetes what are the benefits of bypass vs. stents.  I would ask what would be the optimum lipid control medication.  I would ask as a long term solution (at least 5 years) is bypass more viable than stenting.  These are incredibly difficult questions that the physicians should be answering.  Make sure you ask THEM.  Good Luck!