Tuesday, April 14, 2009


Well, I did both the patients today. As expected, the patient who had three angioplasties over the last 10 years had some minor progression of CAD, but as it was not in a life-threatening location, I chose to advise continual medical therapy. The first patient, 60+ years with CABG when he was 40 years, well he had severe two vessel disease. The stents placed in the previous three angioplasties by me, in the LAD, were patent and functioning well. It perfused the prox LAD to the first septal perforator, and the large LADD1. The LIMA to LAD was large and patent, and it perfused the mid and distal LAD well. All the venous grafts are occluded. I spend 3 hours helping him. He was lucky. I was able to open the chronically occluded SVG to RCA, without complications. I used about 300 cc of dye ( remember he had diabetes and renal failure ) and in CCU after the procedure, he had PU twice already. I am sure that he will be ok for awhile.
Well that was the update.
I am convinced that CABG should not be done in the young ( 50 years or below ) unless the artery cannot be opened with angioplasty, and I mean by interventionist who are experienced, with high caseloads.

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