Submitted by Dr T on March 16, 2014 – 10:19am
Question:
Dear Dr T,
I underwent CABG x3 in Sept 2012 and have recently had access to my medical reports and I was wondering if I could trouble you to explain some of the medical terms to me.
1. Result of catheterisation pre-op showed ‘right coronary artery had no obstructive disease. The left main stem had a critical distal lesion – 90% and this was a true bifurcation lesion involving the ostia of both the left circumflex and LAD. The LAD had some mild disease after a large diagonal branch. The left circumflex had no other significant disease apart from the ostium. Left ventricular function was good.
2. Intra operatively patient had a pedicle LIMA anastomosed to the LAD, vein graft to the diagonal, vein graft to OM1.
I heard the term widow maker mentioned to me on the ward, is this what I had with some or one of my blockages Dr T? I was also wondering, based on the pre-op findings, just how serious was my situation back then?
Many thanks for listening
James
I underwent CABG x3 in Sept 2012 and have recently had access to my medical reports and I was wondering if I could trouble you to explain some of the medical terms to me.
1. Result of catheterisation pre-op showed ‘right coronary artery had no obstructive disease. The left main stem had a critical distal lesion – 90% and this was a true bifurcation lesion involving the ostia of both the left circumflex and LAD. The LAD had some mild disease after a large diagonal branch. The left circumflex had no other significant disease apart from the ostium. Left ventricular function was good.
2. Intra operatively patient had a pedicle LIMA anastomosed to the LAD, vein graft to the diagonal, vein graft to OM1.
I heard the term widow maker mentioned to me on the ward, is this what I had with some or one of my blockages Dr T? I was also wondering, based on the pre-op findings, just how serious was my situation back then?
Many thanks for listening
James
Hi James,
- The term LIMA refers to a Left Internal Mammary Artery graft.
- This artery is usually connected to the left anterior descending artery and/or one of its major branches, as was done in your case. The major advantage of using internal mammary arteries is that they tend to remain open longer than venous grafts and much longer than PCI. Ten years after coronary artery bypass graft surgery (CABG), 90% of internal mammary arteries and 66% of vein grafts are usually still working. If compared with PCI (10-15% failure rates within one year), it is easy to understand why CABG is the preferred procedure in patients with extensive coronary artery disease.
- The term widow-maker refers to a critical 90% or greater Left main blockage (stenosis), because it supplies blood to the left side of your heart. If blocked, a large portion of your heart no longer gets blood, causing a major heart attack, stops pumping blood to your body and you probably would not survive! Studies performed before became the standard of care showed that almost 40% of patients died within three years. Other studies, comparing coronary artery bypass graft surgery (CABG) to PCI or medical therapy, led to strong recommendations for CABG.
- Here is my own take at choice of procedures for coronary artery disease..
Hope this helps,