What Does It Mean to Get a Stent?

Hi mate. No stents for me had double by pass. But your info suggests that stents are needed. You can always get another opinion from another cardiologist. HT

Thanks jdiane. I am trying to participate in a trial for my valve replacement. I don't remember if it is pig or bovine, but it's not mechanical. I meet all the criteria except I am still asymptomatic, at least for the symptoms required to participate. I don't have angina or trouble breathing or get dizzy.

Studies show that stents don't prevent future heart attacks or increase life expectancy. Stents are often used successfully for people suffering from angina. Stents are also used during a heart attack if an artery is completely blocked. They don't prevent heart attacks and strokes because they are only correcting a very small fraction of the artery walls, so heart attacks can occur somewhere other than where the stent was placed.

I'm just not convinced a stent, with its inherent risks, is the right option for me. I am finding it difficult to get a straight answer from a cardiologist, as stents are still standard practice in most hospitals because they are big money makers. Even though diet has proven to be at least as effective as stents in many cases, hospitals would go broke if they just put heart patients on a good heart diet.

What I am looking for is if A exists, get a stent; for anything else, get on a heart diet. I find hints, but not specifics.

Post Edited (richh) : 6/20/2019 10:09:05 AM (GMT-6)

Susie, but is the fatigue caused by the aortic valve blockage (.81 cm2 AVA), or by 70%-80% blockage of OM2? My guess is it's the aortic valve blockage causing the fatigue.

They want to do a stent because they will already be in my heart to replace the aortic valve. I don't think that is an acceptable explanation. I want to know if they would still do a stent if they weren't replacing the aortic valve and what is the risk/benefit analysis of getting a stent. Just because they have been wrongly putting in stents for the last 15 years, doesn't mean it is the right thing to do. I get the impression this is more to protect the doctor and the hospital than to reduce my chances of having a heart attack or stroke.

I want to have TAVR and not open heart surgery for the valve replacement. As I am considered at low risk for surgery, the only way I can get TAVR is through a trial. I can't get approved for trial until I have symptoms.

It's pretty dumb. I don't have symptoms because I am taking steps to keep my heart as strong as possible, keeping inflammation to a minimum, and have driven my LDL, triglycerides, and ldl particle number way down. Basically I am doing what they tell you to do AFTER you have had a heart attack.

In a recent comparison of TAVR and SAVR, TAVR was considered safer on most counts. The trial I am "in" is a continuation of a trial. Initially half got TAVR and half SAVR. That part of the trial is completed and at this point everyone receives TAVR so they can continue to collect data. Medicare doesn't cover low risk patients for TAVR, so if I can't get TAVR through this trial, I have to have SAVR through Medicare.

Even though I was diagnosed with severe aortic stenosis almost a year ago, I have had to wait for it to progress even more and to become symptomatic. The fatigue I am having is relatively new, only being so overwhelming the last couple of weeks. I have suffered with fatigue my entire adult life, but this is much worse than anything I have had before.

I disagree about surgeons being the most reliable source. They are experts in their field, but most are extremely ignorant of diet and lifestyle treatments. The Ornish Program for Reversing Heart Disease is approved by Medicare, but ask a cardiologist or surgeon about it and see if they know anything at all about the program - the old adage abut give someone a hammer and everything looks like a nail.

Last January I had cardiac catheterization to make sure they could do TAVR. about 1/2 hour after the procedure, my cardiologist comes in and very excitedly tells me I have blocked arteries and need either stents or bypass surgery. He gave me the impression it was extremely serious and something that needed immediate attention. The cardiologist that did the cath was with him and gave him a funny look.

Then he had the surgeon come in to talk to me. After we talked for a couple of minutes the surgeon says "I don't know exactly why he wanted me to talk to you".

A couple of days later I get notified through the patient site that my condition was discussed at the weekly TAVR meeting and was not considered critical and to come back in 5 months. That's all that was said. I tried twice to get more information from my cardiologist and got nowhere. I think he had over-reacted and at the meeting was out voted by the other cardiologists.

I now had a trust issue with that cardiologist and changed to a different cardiologist at a different institution. So far I have met with the lead cardiologist who says I am a good candidate for TAVR, but have to be symptomatic to qualify. He scheduled me for another echo which I had a few weeks ago and have a follow-up appointment in Aug. There was little change in echo from January to June.

Hope the trial goes forth. The cardiologist i had an assoc prof told me....we tell the surgeon what is needed and they do the cut.

The surgeon will only deviate if anomalies are found. Obviously each individual person and surgery is unique, however they tend to stick to a plan. Well...this is what i know...esp downunder.
Keep 💪. HT

I trust the surgeon....at the col face. They see it...know it. Yrs and yrs of training

Answer. Yes...in my non medical opinion. 80 percent is bypass territory....i had a 60 in one and 75 in another. Double bypass.

Cpmorbid coditions and the area of blockage will dictate the method...stent or by pass. My knoweledge and experience indicates that it 'seems' you require surgery. Esp 80percent blockage. HT

It has put me in a better place...and has increased my life expectancy as i was dx with cad.

Am clear. No cad. My trigs chol hdl ldl good. Diabetes on the imprpve.

What i shoved down my neck...food got me into the mess. Diabetes and smoking the surgeon expressed.

Kidneys back to stable bp stable. HT

Diet is crucial. I learnt sooo much by doing the post op cardiac rehab prohram.

Hope the moo valve gives ya a few more yrs. Great input.
Keep strong. HT

Good to read that you will now be able to get the procedure done that you wanted. With the combination of the two procedures you will feel better with the fatigue.

Good luck.

Rich
How does the dr know that you have a 70% and 80% blockage. What test showed that? Was it a cat scan? Because I had a cat scan of the heart and it showed a 50 to 70% blockage and my cardiologist said the middle range is not accurate. He had me do a nuclear stress test and I had normal blood flow. I had another nuclear stress test a year later had that was normal

But every time I get a pain in my chest or shoulder or in between my shoulder blades I panic.

Heart disease runs in my family on my mother’s side. I’m 62 and have a chronic condition of Lyme disease and probably leaky gut too. I get all kinds of symptoms and am in a constant panic.

Yes. That test is definitive. My dr won’t do it because he feels I’m fine. The nuclear was good.
Thanks for your reply.

How are you doing now? I realized this was a bit of an old post.

That’s great! Wishing you continued good health!