You have been having on and off chest pain for the last three months. You are always tired and short of breath. Like most people in your situation you ignored these symptoms hoping they would just resolve on their own. You finally face your fears and consult a cardiologist. After a few tests your doctors tell you that you have severe coronary artery blockages but that there is nothing they can do about it. Do not panic. This is the time to organize your thoughts and figure out how to improve your health and get a second opinion. New advanced surgical techniques can help even the most desperate cases. Here is what you need to know and five questions to ask:
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What makes me inoperable? Doctors might be inclined to deem your heart condition inoperable for several reasons. What a doctor can do for you depends on his or her personal level of technical skills and expertise and can vary significantly among specialty physicians. An inoperable coronary case for a surgeon with limited expertise in high risk coronary surgery could be a pretty straightforward proposition for an expert heart surgeon in a reputable center.
Is it because of my other medical problems? Some patients are affected by lung, kidney or liver problems that can increase the risk of surgery. Keep in mind that a high risk coronary bypass could still be your best option.
Are my coronaries so badly diseased that a stent or a balloon angioplasty cannot be an option? Certain types of blockages at bifurcations or at the take off of a coronary artery branch cannot be safely treated with stents but surgery is still a much better and reliable option. Resist the temptation to discard a surgical solution simply because of fear. If your chances to restore your quality of life and live a long life are much better with surgery, it is a no-brainer. Do not let your fears take over your better judgement.
Is it because of my age? Age should never be an absolute contraindication to surgery. Most experienced cardiac surgeons have successfully treated patients well into their 80's and 90's. At those levels of expertise it is a known fact that some patients are physiologically younger than their stated age and can have the same excellent surgical outcomes of much younger patients and return to an independent, meaningful life.
Can you discuss my case with another surgeon? Do not be shy about seeking a second opinion. Your life might depend on it and most physicians will not mind doing that. It is not about their egoes. It is about the rest of your life!!
Different geographical areas in the U.S. and different surgeons might have a higher or lower threshold to recommend surgery based on the local expertise. A reputable minimally invasive heart center can offer reliable and successful open heart surgery operations even in high risk heart patients. Do your own investigating and you might find the best options for you. Most high risk heart surgery surgeons will be glad to fill you in about your options.
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