my mother in law when to emergency room she was told had a minor heart attack she had 100% blockage the doctors placed one stent. Now the question is should she have more stents placed or have bypass surgery but the the surgeon suggest she needs more stents placed becuase her left artery is blocked the right artery is blocked and the middle artery is blocked but its not really needed. Is this the best decision to have stents placed or should she have bypass surgery? Her medical history is 61 year old african american, highblood pressure, and diabetes.
Hi, As you have mentioned your mother in law-61 yr, Diabetic, Hypertensive, African-American. She had heart attack for which she must have undergone coronary angiography and subsequently angioplasty (stenting of 100% blocked vessel which is called as culprit vessel as blockage in that vessel is responsible for symptoms of heart attack and ECG changes) Also there are blockages in other vessels as you have mentioned there is need for revascularization procedure either stenting or coronary bypass surgery. Either of two procedures will be selected depending on upon1) age of patient usually in young patient stenting is preferred. 2)nature of blockage like in patients with long-standing Diabetes there are usually diffuse blockages (long segment of vessel is narrowed) in such patients bypass surgery is preferred over stenting. 3)Number of blockages more the number bypass is preferred. 4) Other comorbid conditions. 5) Duration of hospitalizations usually less with stenting. 6) In case of Calcification of vessels bypass surgery is preferred.