stents vs bypass surgery

[deeoeraclea]

For a few months, I have been feeling tightness in my chest when walking up hills. So, I decided to have a stress test done (first step was actually and ECG, which was normal). After doing the stress test, rather than sending me home, a cardiologist entered the room and told me she though I should be admitted to the ER, as my stress test was abnormal. Upon being admitted to the ER, they sent me to the cath lab, where they found partial blockages in three arteries leading to the heart. The recommendation now is to either have stents put in to open the blocked arteries or have a bypass operation.

Putting stents in is a very simple procedure, which can be done without a hospital stay, and which would allow me to return to full activities within just a few days. The bypass, on the other hand, is a major operation, which would be done under general anesthesia, require a 5 day hospital stay, and which would take months to recover from. So, all else being equal, the stents seem like a much better option -- both because of the shorter recovery and the lower risk of complications during the procedure.

But, the surgeon I spoke with said that, because I am young (42), the bypass would be a better option, as it has a superior long-term outcome. I'm not sure exactly what that means. But, what I think I gathered is the bypass is far more likely to be a one and done thing, whereas the stents may require further stents in the future, which doesn't seem so bad, given how simple the stent procedure is. But, I think there may be some limit to the number of times one can put in a stent before all bridges have been burned.

Anyway, all of this is just to ask: do any of you have strong opinions on which of the two options (stents or bypass) is best for a young male that wants to remain active? Any information you can provide or resources you can point me to would be appreciated.

 

[sushak]

For a few months, I have been feeling tightness in my chest when walking up hills. So, I decided to have a stress test done (first step was actually and ECG, which was normal). After doing the stress test, rather than sending me home, a cardiologist entered the room and told me she though I should be admitted to the ER, as my stress test was abnormal. Upon being admitted to the ER, they sent me to the cath lab, where they found partial blockages in three arteries leading to the heart. The recommendation now is to either have stents put in to open the blocked arteries or have a bypass operation.

Putting stents in is a very simple procedure, which can be done without a hospital stay, and which would allow me to return to full activities within just a few days. The bypass, on the other hand, is a major operation, which would be done under general anesthesia, require a 5 day hospital stay, and which would take months to recover from. So, all else being equal, the stents seem like a much better option -- both because of the shorter recovery and the lower risk of complications during the procedure.

But, the surgeon I spoke with said that, because I am young (42), the bypass would be a better option, as it has a superior long-term outcome. I'm not sure exactly what that means. But, what I think I gathered is the bypass is far more likely to be a one and done thing, whereas the stents may require further stents in the future, which doesn't seem so bad, given how simple the stent procedure is. But, I think there may be some limit to the number of times one can put in a stent before all bridges have been burned.

Anyway, all of this is just to ask: do any of you have strong opinions on which of the two options (stents or bypass) is best for a young male that wants to remain active? Any information you can provide or resources you can point me to would be appreciated.

I don't have anything to add to help in regards to your questions but it would be cool if you could expand on how you got into this situation, was it through ped use, lifestyle/weight or some hereditary issue? 42 is so young!

 

[deeoeraclea]

I had very high LDL (~400 mg/dL) from the ages of 23 - 40 and did nothing about it. I figured that, since i was lean, ate a healthy diet, and exercised regularly, I had nothing to worry about. I had a coronary calcium scan done two years ago, and found that I had a score of about 35, which is not high, but it should have been zero at my age. At that point, I got serious about lowering my LDL. Presently, I am on Rapatha (a pcsk-0 inhibitor) and Zetia. My LDL has been in the normal reference rage for a while now. But, you can't undo 15 years of plaque build-up after it happens.

That said, I was surprised to find that I had a partial blockage now, given the calcium CT scan I had just a few years ago. Part of me wonders if 3 doses of the Pfizer vaccine caused a problem. But, even if it did, nothing I can do about it now.

I very much doubt the 140 mg/week of testosterone I am taking had any affect. In fact, my cholesterol went DOWN after getting on testosterone.

 

[bigMoJo]

Difficult and tough situation... but man, you are lucky to be alive! Let's be happy about that! Also, at least you can decide stents or bypass.

Heart disease runs in my family. My dad had a heart attack at 50, but survived with angioplasty. Later received two stents. My cousin had bypass. However, his was a situation like yours... but, they made him stay and bypass was the only option. He's not an athlete or a lifter. So, I don't think he ever thinks about it.

In your case, I think the cut on the chest bone for a bypass would take alot out of you (you know this)... making recovery lengthy, and training possibly more difficult in the future. It may interfere with your quailty of life. I think your angle on the stents is right.

Although, I don't like when a doctor doesn't inform me enough to where I feel there was a lack of information. As you said, you're not sure about the "one and done" and so on. Definitely get a second or third opinion if you have time. It's sad to say, but we have alot of doctors that are full of sh**.

Your thought process on all this seems very sound. Please share how things progress. Wish you the best and a long and healthy life.