Question

Case: A 57-year-old man with triple coronary artery disease was scheduled for coronary artery bypass grafting. He had a myocardial infarction 7 months ago. He was taking nitroglycerin, digoxin, propranolol, isosorbide dinitrate (Isordil), and nifedipine. His blood pressure was 120/80 mm Hg and his heart rate 60 beats per minute.

1. What is triple-vessel coronary artery disease?
2. What are the indications for coronary artery bypass grafting?
3. What are the results of coronary artery bypass surgery?

Answer 1

Ans) Triple-vessel coronary artery disease:

- Blockage of this vessel can have severe consequences. Patients with triple vessel disease, meaning that 3 big vessels (the left anterior descending, right coronary and circumflex arteries) have blockages from atherosclerotic plaques.

Coronary artery bypass grafting:

- A surgery used to improve blood flow to the heart in an effort to treat coronary artery disease.
-A blood vessel is removed or redirects from one area of the body and placed around the area (s) of narrowing to "bypass" the blockages and restore blood flow to the heart muscle .

Indications:

-significant left main disease
-multi-vessel (3-vessel) disease; /if a branch of one of the 3 branches is affected, it is an indication/
-diabetics (+/- insulin dependence)
stent perforates, or gets stuck in artery of cath lab
in-stent stenosis.

Results of coronary artery bypass surgery:

- Side effects often go away within 4 to 6 weeks after surgery, but may include:

• Discomfort or itching from healing incisions.

• Swelling of the area where an artery or vein was removed for grafting.

• Muscle pain or tightness in the shoulders and upper back.