Herb,
I had CABGx5 and they used my left mammary artery for my LAD. The remaining four grafts were veinous grafts from my legs. Based on what I've read, this is considered good practice because arterial grafts tend to remain unblocked better and longer than vein grafts, but I have never heard of anyone doing five arterial grafts. I imagine there are technical reasons for this, including availability of appropriate arteries, location and perhaps other factors, but I have not researched this issue any further. I was content that they utilized my left mammary artery for the big LAD and that this was the preferred course of treatment.
I can also tell you that I never experienced any angina, before or after surgery, including during or after vigorous physical activity such as running and lifting maximum weights for low reps and walking friends into the ground at a rapid pace after a heavy meal in freezing weather, all shortly before my heart attack. It is why people (including a cardiologist friend) were shocked that I had a heart attack and such severe blockages. I guess family history, in my case, trumped all other factors. Based in my utter lack of angina or other symptoms prior to the heart attack, the fact that I was told I had excellent collateral circulation despite the blockages and some recent and not so recent studies I've read that mortality rates from blockages are NOT materially improved by CABG surgery over purely medical treatment, although angina problems are improved, I have wondered whether CABG surgery was unnecessary in my case and whether I might have done just as well by only taking the Lipitor, baby aspirin and metoprolol that I now take anyway. By the way, it is now three years post-CABG for me and both a recent echo and a recent nuclear stress test reveal that my grafts all remain clear.
All's well that ends well, so I'm not complaining, but I do have a fair degree of scientific skepticism about the state of medical knowledge in this area, and I wonder about the tendency of medicine to start by bludgeoning problems to death, only to subsequently discover that there are more elegant solutions, for example lobotomies and leucotomies being replaced by drug treatments in psychiatry and radical mastectomies being replaced in many cases with lumpectomies and radiation in the treatment of breast cancer. If there are any physicians, including but not limited to cardiologists, who are reading this, I invite their comments. Maybe I'm missing the picture by my intellectual musings in areas where I have no formal scientific training but, as the old TV commercial used to say, "inquiring minds want to know."
Good health, Herb!
Ira
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Ira Reid
Hoboken NJ
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