Why would a patient not be a good candidate for heart bypass surgery and already have two stents placed?
Question by Bn: Why would a patient not be a good candidate for heart bypass surgery and already have two stents placed?
My father-in-law is 58yrs old and used to be a heavy smoker. They have put in two stents and wanted to do bypass surgery. But they told him they have done all they could for him and he was not a good candidate for surgery. What are his chances of survival and why would he not be able to have the surgery?
Best answer:
Answer by Nurse For 20 Years
No one can predict his chances without knowing all the facts of his case. He would be a poor candidate for surgery if he has any preexisting conditions that cause his overall health to be poor or fragile. Without knowing more, its anybody’s guess. Ask his doctor to explain further. That’s what the doctor is there for. Don’t just take his word for it; ask questions.
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Bn,
Without full details of tests and examinations that have been done, it is not possible to answer this question. There are many reasons why a patient is not a good candidate for heart surgery. First and foremost the condition of the heart muscle. Also whether the surgeon is considering an open or a closed procedure. The traditional full sternotomy is usually considered to have advantages and drawbacks – The patient is placed on heart-lung bypass which allows oxygenated blood to circulate to the body while it bypasses the heart. The heart-lung bypass machine allows the surgeon to stop the heart and perform the surgery while the heart muscle is not moving. The benefit of a full sternotomy is full exposure. The surgeon can reach all of the coronary arteries and manipulate the heart. The disadvantages are a longer recovery period for the patient and significant musculo-skeletal discomfort. There is also higher risk of stroke, kidney damage and bleeding when a patient is placed on a heart-lung bypass machine. All patients undergoing heart surgery are candidates for this approach. The same surgery with the ‘off by-pass’ approach offers the surgeon the same benefits with less risk to the patient. This puts stress on the heart and a patient with a weakened heart muscle would not be considered for this approach. A partial sternotomy is less stressful but as there is less visibility for the surgeon, it requires a modicum of experience by the surgeon, which should be checked beforehand. All this is not really of any importance unless heart surgery is going to take place. To discover the actual reasons that your father in law has been considered as not suitable, you will have to speak with the doctor who examined him. To enquire of his prognosis you will have to refer to his doctor or/and cardiologist.I regret that I am not able to give the answer to your question. I wish him well.
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Hope this helps
matador 89
Consult the doctor whether your father-in-law is a good candidate for Off-Pump Coronary Artery Bypass Graft (OPCABG). In certain cases, a patient, who is not a good candidate for conventional CABG, may be a good candidate for OPCABG.
The main difference between beating heart surgery and conventional CABG surgery is the heart-lung machine. During conventional CABG surgery, your heart is stopped. The heart-lung machine handles circulation for your body. For some patients, this can increase their risk of stroke, or other complications.
probably cardiac necrosis with which even if u do a bypass no use, or other renal causes.
your father in-law is about my age, i would try a different hospital . the hospital i went to saved my life . here it is , when i was there, people all over the country went there .
Hi Bn,
You seem to know the answer. The answer is in your question, ” …used to be a heavy smoker.” He has smoked his lungs and saving the heart is not of much use without the lungs.