Dear Dr. Hibberd: My husband has four blocked arteries but has developed collateral circulation. His cardiologist thinks that he is a good candidate for medical therapy, diet, exercise, and rehab. Everyone thinks he is crazy not to have bypass surgery. What do you think?
Answer:
You have a cardiologist who is keeping up with current recommendations. In multi-vessel heart disease where collateral flow has been established and is sufficient, the long-term survival of effective medical management versus bypass appears to be at least equivalent or perhaps better.
The idea of bypass grafting is to "bypass" or bridge the diseased segment to allow unimpeded delivery of oxygen and nutrients to the heart muscle. He has already accomplished that by collateral flow. Also, when a long-term blockage is stented open, it rarely stays open.
Continue with the preventive measures your cardiologist has advised. Aim to reduce the LDL to less than 80, and boost HDL to over 60 if possible, so plaque regression may occur. Control other risk factors that may apply, especially stopping smoking. If your husband's blood pressure is elevated, controlling this close to 120/80 will also help prevent further vascular disease.
Avoid listening to friends for medical advice. That is why you have a cardiologist, who clearly knows what is best for both of you.
© 2012 Newsmax. All rights reserved.
