“When a very fit 73-year-old with a family history of heart disease reports several episodes of exertional chest pain, you don’t dillydally,” Dr. Heller told me.
Dr. Hammoud said his decision to send Jeff for surgery rather than stenting was endorsed by interventional cardiologists, the doctors who insert stents. They reviewed Jeff’s angiogram and agreed that bypass surgery was a better option given the severity of left main blockage, the extent of his disease and his otherwise good health, Dr. Hammoud said.
The left main artery supplies blood to two-thirds of the heart, and if it becomes totally obstructed, the patient usually dies without immediate medical intervention. When there is an 80 percent blockage, a complete closure can occur at any time if a small clot or piece of plaque should fill in the remaining opening in this artery.
Still, surgery, especially heart surgery, is not a walk in the park, so it’s important to review the benefits, risks and recovery issues with the surgeon and, if possible, one’s doctor and family members before deciding how to proceed.
Short-term surgical risks include heart attack, stroke, kidney problems, even death, all of which occur most often in people who, unlike Jeff, were in poor shape to begin with. The overall mortality rate is about one in 200.
When Jeff was told that open-heart surgery would give him 20 more years with a healthy heart, he decided it was worth enduring three hours of surgery and four to six weeks of postoperative recovery that included no driving.
He is now devoted to a heart-healthy diet that includes no added salt, lots of vegetables, fish and skinless poultry but little or no meat and saturated fat. Gone from his larder are butter, cheese, full-fat ice cream and store-bought pies and cakes. Nutritional information and ingredients labels are now assiduously consulted before any packaged food is purchased.
Within two weeks of surgery, he began working on a backlog of legal cases. He expects to soon be back on the tennis court, trying cases and hauling wood to help heat his home in snow country.
Source : Nytimes
