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Opinions on Stents v Bypass surger for my 73yr old MIL-UPDATED

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Opinions on Stents v Bypass surger for my 73yr old MIL-UPDATED

Old 06-18-2018, 05:58 PM
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Default Opinions on Stents v Bypass surger for my 73yr old MIL-UPDATED

Quick background on my MIL, she had a heart cath Friday and Dr said she had 3 main arteries 90% blocked 3 others more than 70%. He did not do stents but told my Wife and SIL that he felt with that bypass surgery would be a much better way to solve the issue

MIL is in pretty good health for most part but has been through a 3 yr ordeal with my FIL battling prostate cancer which moved to his bones along with diabetes taking a toll on his body. Lost 1 leg 3 yrs earlier and before he died they removed other leg. He has been pretty much bed ridden the last 2-3 yrs and naturally it has taken a mental and physical toll on my MIL. FIL passed away March 20th after being in the hospital since right after Christmas

We have noticed she gets very winded and loss of energy . She really has no other serious health issues to speak of

Well now she is second guessing having bypass surgery and just go back and let them do stents . Dr said he would do 2 at a time and give her a couple weeks in between. I know the bypass would really take care of her issue long term but not sure she will do the rehab needed with bypass surgery(she is not over weight by any means and is a nice looking 73 yr old lady , always has been very attractive ) just have NEVER known her to do a minutes worth of excersise in her life, NEVER


Well now she is asking my opinion and I have told her only my thoughts but end of day it is her decision .

Anyone every known anyone that has had this decision

My Dad had bypass surgery at 66 yrs old and never had another heart issue (had 5-6 prior heart attacks if you count the "mild " heart attacks ). My Dad was always very active and died at 83 yrs old and his heart was still going fine

I am more worried about the emotional recovery than the physical I think.

Thanks for any input on this, I make fun of my MIL but she honestly is like a 2nd Mom to me

Last edited by tprice; 06-23-2018 at 04:40 AM.
Old 06-18-2018, 06:06 PM
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My Mom had a stent in her mid 70's. She just turned 81 and no heart issues since. It's a much less invasive procedure. Getting cut open and your ribs cracked apart at that age for a triple bypass ain't a good thing, if you can avoid it. Takes forever to heal.

Disclaimer: I am not a doctor, I only play one on the Intarwebs!
Old 06-18-2018, 06:11 PM
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U know the drill..

Pics of mother- in - law...
just kidding..

each case is different... which arteries, location of blockage, etc...

can an always get more opinions from interventional cardiologists

if ending up with stent decision...do it in a hospital where emergency bypass surgery is available just in case..
Old 06-18-2018, 06:13 PM
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We got boned by our hospital..$40,000 just for the stent.
Old 06-18-2018, 06:14 PM
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My brother had a single vessel blockage so they went with a stent. My FIL had multiple blocked arteries and vessels and they went with a triple (may have been quadruple) bypass (at 80). He looks and feels healthier now at 84 that he felt the past 20 years. I think I would trust the specialist on this one but nothing prevents a second opinion.
Old 06-18-2018, 06:22 PM
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No question....second opinion...then make a move! Do not delay
Old 06-18-2018, 06:22 PM
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Originally Posted by BACKTOTHESEA View Post
My brother had a single vessel blockage so they went with a stent. My FIL had multiple blocked arteries and vessels and they went with a triple (may have been quadruple) bypass (at 80). He looks and feels healthier now at 84 that he felt the past 20 years. I think I would trust the specialist on this one but nothing prevents a second opinion.


Basically what Dr told her/them. He said over time that many stents can cause undo pressure on each other and possibly one collapse . MIL I think is dreading the recovery period to be honest

Heck my Grandmother had bypass surgery at 85 yrs old, lived until early 90's. Physically she got over it but mentally she never really did to be honest . But my Grandmother was still working in our family tax business up until this point and heck that is when we did tax returns by hand
Old 06-18-2018, 06:39 PM
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I am going through a medical problem now and it the mental aspect rather than the physical that concerns me the most. The patient has to come to terms with the problem and agree to the possible outcomes before going ahead. Layout ALL possibilities to the person, both good and bad. Emergencys are a different story.
Remember, your MIL has just seen her husband pass and she thinks that she is not far behind. In her mind stents mend a lot faster than by pass procedure and will give her more “positive” time.

Old 06-18-2018, 07:33 PM
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Originally Posted by Jimm View Post
I am going through a medical problem now and it the mental aspect rather than the physical that concerns me the most. The patient has to come to terms with the problem and agree to the possible outcomes before going ahead. Layout ALL possibilities to the person, both good and bad. Emergencys are a different story.
Remember, your MIL has just seen her husband pass and she thinks that she is not far behind. In her mind stents mend a lot faster than by pass procedure and will give her more “positive” time.


You hit the nail on the head. I honestly think physically she would be ok BUT not sure mentally she is up for it.


Admiral and I were talking tonight and she is thinking more along the lines of stents now and IF there is an issue down the road back to bypass surgery

Honesty Admiral is pretty torn up about this, getting this news on Friday of Fathers Day weekend on the first year she and her sis did not have their Dad
Old 06-18-2018, 08:48 PM
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If the cardiologist recommends bypass grafts, then support her in having the bypass grafts. (Not stenting)
Runoff is most important. That's the flow observed after the obstruction after the narrowing. Bypass grafts offer greater blood pressure distal (after) the graft insertion.
Stenting does not necessarily increase the blood pressure in the vessel downstream from the obstruction. Plus, the number of stents required (greater than three?) may increase the chance of morbidity and clotting downstream.

Cardiologists and Cardiac Surgeons face this situation all the time. Why second guess them? Leave it to the pro's.
Old 06-18-2018, 09:17 PM
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My dad had x3 bypass at 80. He was mentally and physically very healthy. He lived 12 more happy and healthy years until 92. He was still driving and hanging shelves 10 days before the end. That said If she has other medical issues that can complicate things and there is always the risk of stroke or death.
Old 06-18-2018, 09:28 PM
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Originally Posted by Jimm View Post
I am going through a medical problem now and it the mental aspect rather than the physical that concerns me the most. The patient has to come to terms with the problem and agree to the possible outcomes before going ahead. Layout ALL possibilities to the person, both good and bad. Emergencys are a different story.
Remember, your MIL has just seen her husband pass and she thinks that she is not far behind. In her mind stents mend a lot faster than by pass procedure and will give her more “positive” time.

This could complicate things. I had a neighbor who went in for a minor procedure 2 weeks after her husbands death. She never made it out. Life is strange.
Old 06-19-2018, 05:32 AM
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Originally Posted by dssmith View Post
If the cardiologist recommends bypass grafts, then support her in having the bypass grafts. (Not stenting)
Runoff is most important. That's the flow observed after the obstruction after the narrowing. Bypass grafts offer greater blood pressure distal (after) the graft insertion.
Stenting does not necessarily increase the blood pressure in the vessel downstream from the obstruction. Plus, the number of stents required (greater than three?) may increase the chance of morbidity and clotting downstream.

Cardiologists and Cardiac Surgeons face this situation all the time. Why second guess them? Leave it to the pro's.
This. Also, talk to the doctors about the cardiac rehab program, and if you're concerned about the impact of surgery on her emotional state, discuss that specifically with them.
Old 06-19-2018, 05:53 AM
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5 Stents 10 years ago. Cath this year showed stents holding up well. I am only 68 though. Follow MD’s advice. Very little pain and quick recovery. Good luck. Also no scars on my beach body and have never had to use nitro.
Old 06-19-2018, 06:25 AM
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Bunch of data coming out on overuse of stents. Obviously each case is different so you need to trust dock. My 73 also friend retired surgeon friend just had a open heart surgery for a valve replacement and the recovery is brutal. He was in decent shape and it took six months for full recovery. He ran off to cleveland clinic to get a doctor that did lots of them.
Old 06-19-2018, 06:29 AM
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She is 73 and bypass is major surgery with long recovery time and a fairly decent risk at that age. Stints all of the way.
Old 06-19-2018, 06:31 AM
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Originally Posted by dssmith View Post
If the cardiologist recommends bypass grafts, then support her in having the bypass grafts. (Not stenting)
Runoff is most important. That's the flow observed after the obstruction after the narrowing. Bypass grafts offer greater blood pressure distal (after) the graft insertion.
Stenting does not necessarily increase the blood pressure in the vessel downstream from the obstruction. Plus, the number of stents required (greater than three?) may increase the chance of morbidity and clotting downstream.

Cardiologists and Cardiac Surgeons face this situation all the time. Why second guess them? Leave it to the pro's.

While I was not there when Dr explained it that sounds like what Admiral was telling them Dr said. LOVE my SIL to death but she is a damn office manager for a medical practice and SHE THINKS she knows as much as MD's. I am sure you have seen the types before

MIL one minute wants to have surgery and next she says hell no. As BS crazy as she can be at times she has no fear of anything and have to admit she loves some drama in her life (wife always says it is her Mom's ONLY child syndrome )
Old 06-19-2018, 06:36 AM
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My dad who is 79 just had triple bypass on May 17th. He was home 4 days after and has done great. He said the only real pain he had was the first couple days after the operation. He just started rehab and he did exercise prior to the procedure. If your her only family be prepared for her to live with you for a month or more after the procedure.
Old 06-19-2018, 08:02 AM
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Originally Posted by Lorne Greene View Post
She is 73 and bypass is major surgery with long recovery time and a fairly decent risk at that age. Stints all of the way.
pretty bold statement being you have never laid eyes on the lady, much less actually viewed the testing results with your own eyes! so i assume your an international cardiologist and most likely president of the american cardiology association? if non of the above you really shouldnt give this kind of advise based on what you read on the internet
Old 06-19-2018, 08:03 AM
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take her for a second opinion, then make the best decision from there! that will provide reassurance to the MIL

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