Q. Are there any other options than bypass or angioplasty for blocked heart valves?

Answered by
Dr. Muhammad Zohaib Siddiq
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jan 13, 2019

Hello doctor,

My father is 51 years old with normal weight (fit), yet he has diabetes and now a heart problem. Just got an angina attack. Doctors say bypass or angioplasty are the options since three of his heart valves are 70 to 80 % blocked. He is on a strict diet with no oil at all and only salad. We have recently heard that there is an option EECP, so we were thinking to jump in that instead of the surgery. Since we are scared and not ready for that mindset yet. My question is that is EECP a good option? My father is feeling alright since 3 to 4 days?

#

Hi,

Welcome to icliniq.com.

Science is based on evidence and experiment. As for as three-vessel disease and diabetes mellitus, the evidence favors CABG (bypass) if there are suitable targets (which means vessels can be attached as a bypass). There are many trials which support this decision. Another option is PCI (means angioplasty).

So if talking about the treatment of choice in your case, it is CABG. If it is not possible or feasible or desired, then the next option is always PCI. Regarding EECP, it is usually reserved for those patients who are neither candidates for CABG nor for PCI, who are on maximum medical treatment and still have chest pain. In such patients, EECP can be an option. EECP is never the first option in those patients in which CABG or PC is possible. Yet medical ethics says always respect patients choice. If the patient does not want to undergo an invasive procedure, then non-invasive procedures such as EECP and medical management can be kept on top. No doubt, EECP is also effective in treating anginal pain. EECP, in fact, causes turbulence in blood in coronary vessels and speeds up the generation of new blood vessels in the heart, but does not open already blocked vessels. In my opinion, I will put CABG on top, PC on the second and EECP on third. But if the patient and his family want EECP, then I will respect their wish.


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