What is the survival rate after bypass surgery?

Question

Hi doctor,

I have attached the reports of my father-in-law. He had a severe heart attack yesterday and is now somewhat stable. We need your guidance on how to proceed further. Should we opt for angioplasty or bypass surgery? What are the survival chances if we choose the bypass surgery? Currently, he is reluctant to stay and insists on going home. We are trying to convince him to undergo treatment, but it may take some time. Is it safe to wait for about a month if he is not ready now?

Please advise.

Answer 1

Hi,

Welcome to icliniq.com.

What is his ejection fraction? The risk of the procedure depends on the ejection fraction. If it is adequate, say above 45 to 50 percent, then the risk of mortality in such surgeries is one to two percent. The preferable and better option for him is bypass surgery, as he is diabetic, and stenting the described lesion is somewhat challenging. Additionally, the long-term outcome would be better with bypass surgery. It should be done as soon as possible because the lesion is critical and 95 percent blocked. We cannot predict the future course, whether he will remain stable or suffer another heart attack due to this. Although medications can work well to reduce such risks, it is advisable to proceed earlier.

Thanks and regards.

Answer 2

Hi,

Welcome back to icliniq.com.

This is not mentioned in the report (attachments removed to protect the patient’s identity). Blood thinners like Aspirin and Clopidogrel need to be stopped five days prior to surgery, and the doctor will start administering Heparin during those five days to reduce the risk. This should be acceptable to him. The term 'swelling' is a layman's term, and you should ask the doctor for the technical term so that I can better interpret it. Otherwise, if the patient is stable, waiting for a period of two weeks is fine.

Thanks and regards.