what would your choice be

[ed34]

I had a meeting on friday with a cardiology consultant in a top heart hospital in the UK. I was given a series of options
and basically asked to consider them all and report back with my decision. The problem I have is a very large total
occlusion in the LAD just below the circumflex junction and luckily no heart tissue death. My LAD is like a piece of
thin thread due to the lack of blood supply.

Option 1. An attempt at another bypass.
Option 2. A transplant.
Option 3. Rotablation.
Option 4. Do nothing.

I'm 48 and have been suffering bad angina for 2 years now and cannot do any exertion. I had always led a very active
life and I find it difficult adapting to this way of life. When I consider each option, I seem to come up with :-

Redo bypass. The first CABGx3 failed miserably after just three months and most cardiologists feel this option
would only give some benefit for a short period of time. I just don't see the point to this.

Transplant. With no tissue death and another alternative, I am shocked this was offered. I was told I will have a
80% chance of surviving the first year and a 50% chance of surviving ten years. Not knowing how long this heart
will last I can't weigh up the odds.

Rotablation. One cardiologist feels sure he can remove all the plaque causing the occlusion which will reopen the
LAD. He believes he can stent it successfully. All other cardiologists seem to be disagreeing but maybe this is
because they are afraid to attempt it.

Do nothing. This is like giving up.

I would very much appreciate what others think and what they would go for.

Many thanks

[ed34]

my bypass failed because the two veins closed up after three months which is quite common. The artery used from the chest is still in great shape but was never working
because the surgeon grafted it directly onto the main occlusion in my LAD which was
ridiculous really.

[ed34]

Thank you for your comments. The cardiologist who believes he can treat the occlusion is actually quite good with credentials as I did some investigation. He is the head of research at imperial college in the uk and in st. mary's hospital in london, which is where
I can have the treatment.
Re-stenosis is not likely because rotablation removes ALL the plaque along the artery
lining and the stents will be drug eluting. The only part which worries me is that the stent
will completely lay across the circumflex artery junction so a hole will have to be punched into the side of the stent. I am worried because this is the only vessel basically
keeping me alive, feeding the LAD through newly formed vessels. If this vessel ends up
being damaged, then it's definitely game over.
Another reason I can't face open surgery is that during my CABGx3 the anaesthetic wore
off way too early and I had to endure the stitches being put into my chest. I also had to
endure the 3 drainage tubes being inserted and stitched into place. When you have a
tube down  your throat you cannot talk and I couldn't move my arms because of the pain.
The surgeon knew I was awake because he kept saying "nearly over". I can tell you that
I had him by the scruff of the neck a few months later during a consultation and told him
I will not be responsible for my actions if he ever had the chance to do that to me again.
These are the nightmares I used to read about and never believed it would happen to me.

[jsuter69]

My boyfriend has had similiar heart problems, he's 45yrs old and has had 3 heart attacks, as well as coronary artery disease, last summer he also had a problem with his LAD, it was 95% blocked, his cardiologist suggested a heart cath to stent him, it worked!! He'll be on Plavix for the rest of his life....but he seems to be doing well!!
Not sure how different this is from your health condition...but a transplant? Just seems so traumatic...
You'll be in my prayers!
Julie

[ireneo]

The question I would ask of the rotoablation doctor is what are the odds of restenosis with that treatment? You mentioned the bypass failed; I assume they became clogged again or was it something else?

[Flycaster305]

That's quite a load on you.

Have you tried to post on the Related Expert Forums on this site?  I think that would be something I would do, get input from other professionals.

Have you checked the credentials of the doctor who believes he can take care of the issue with Rotablation?  

Keep us informed.