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Forum Name: Ischemic Heart Disease

Question: 90% + blockage in LAD and RCA


 triamit - Fri Apr 03, 2009 7:03 am

Hi,

Recent angiogram of my mom showed 90%+ blocakge in her LAD and RCA. She is travelling to US on 28-APR-09. I want to know whether it is safe for her to travel?

Also It is for sure that she will need either bypass or angioplasty? Which is better?

What is recovery time in either case in case it is decided to have her surgery done before she comes to US.

Appreciate your valuable suggestions.

Thanks and Regards
Amit
 John Kenyon, CNA - Fri Apr 10, 2009 8:40 pm

User avatar Hi there --

Your mom should, first of all, get cardiology clearance for making the trip. It would probably be fine, assuming she's been stable up til now, but it's just the 8-10 hours in the air with no place to pull over that is of concern.

It's not even certain (though it it likely) that she'll need either bypass surgery or angioplasty with stenting. If she's well enough to consider making this trip she may be relatively asymptomatic, and if so she may have developed significant collateral blood supply, a sort of homemade bypass some hearts develop on their own and which makes the question of invasive corrections less urgent sometimes.

Since she has 90 per cent blockage in two of the major arteries, her coronary anatomy would determine which approach might work better. If the affected vessels are pretty straight, angioplasty may be preferable, although bypass tends to last longer (statistically) and provides more concrete results, One recent study has found neither improves most outcomes over managing things medically, but when there's almost no room left as now, it's kind of a tossup, since most thoracic surgeons prefer to not do fewer than three. That LAD really needs to be opened up if there's no collateral flow, though.

Recovery time post bypass is anywhere from a few weeks to a few months, depending on the individual and unforseen complications. Post angioplasty is usually a matter of days into weeks.

Again, cardiac clearance from a cardiologist, specifically for the flight, would be wise. Also, if she's symptom free, it's a better bet that nothing will happen during that half-day it takes (roughly) to get here from the UK.

I hope this is helpful. It's definitely and deliberately a little vague, because there's a lot we don't know about your mom's situation. If you can fill in the picture more, there's still some time before the flight. Hope this is hlpful. Good luck to you.
 triamit - Fri Apr 10, 2009 9:16 pm

Thanks John for your reply.

Her cardiologist has already given her green signal for the journey.

She is diabetic. She was having 90% blockage in LAD since 2004 and it has remain stable. But blockage in RCA increased from 40% to 90% in this 5 years.

She has no complain of angina or any other complications.

I hope this information might help.

Thanks again
Amit

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