15-20 years post-CABG

[Cabbagehead]

Hi,

I am a 2nd degree nursing student and I graduate in December. yay!

At the end of april my father (58, and w/ no previous diagnoses and in good health) had emergency CABG. He had 5 bypasses. They took his radial artery. I have two questions if anyone can help!

For the past few months i have been looking at the literature and asking opinions in regards to his treatment course. I havent been able to find out too much about what happens when the graft, which is said to last "15-20 yrs" , ceases to be patent. I read that the radial artery is better to use than the saphenous vein... maybe it lasts longer? Anyway, I know he is afraid to ask the question, but I would like to try and find out.

he has also had a-flutter since the surgery. he's been on coumadin this whole time as well as amiodarone which i understand could be serving as a chemical attempt at cardioversion. well, i guess it hasnt worked. the doc says he needs to keep his coumadin at 2 for 4 weeks straight and then they'll do the cardioversion. my dad is skeptical about it because the doc said it may not work and they'll have to repeat it, then if that doesnt work there will be a lifelong course of undesirable drug therapy, or something. I tried to assure him that he should definitely opt for the cardioversion and that 95% of the time it works on the first shot. I hope I wasnt misleading him.

Any opinions welcome!! thank you

~Liz:heartbeat

[cathlabrn]

You always hope that grafts will last a long time. However, over time they could

occlude. A patient could either need bypass surgery again if he is symptomatic.

Many times if it is many years later, when you do the angio you may find the graft

down but the patient has built collaterals and therefore would not require another surgery. If needed, often times you can do plasty on grafts. There are many different scenerios. I have seen patients come with 20+ years on their grafts and they are all patent. Hopefully he will work on keeping a healthy lifestyle and take his medication.

That is so important!!

If he hasn't converted his rhythm with meds, then cardoversion is worth a try. Sometimes you just can't convert them and they have to be managed with meds.

You might convert him and then he'll flip back again later. Cardioversion can be done

more that once. However if that rhythm is stubborn, many people live with fib and get managed on meds.

All of this stuff is scary for patients and their families. Over time they adjust and get more comfortable with their conditions/treatments.

Good Luck!

[dianah, ASN]

Great information, cathlabrn, thank you!

I also strongly encourage you and/or your dad to ask these questions of his cardiologist, and to keep asking (perhaps rephrasing the questions) until both are satisfied with the answers.

Such as, "define 'a lifetime of undesireable drug therapy or something,' " which to me strongly begs for clarification and details.

Even if you, in your research, check stats on % of successful cardioversions, then compare that with the % of pts who may revert back to a flutter at a later date --- these numbers may not reflect your dad's experience. Every patient is different and responds in his own way (and in his own time) to medications and treatments (including cardioversion).

It's all scary and overwhelming; a lot has happened and changed in a short period of time.

Keep asking.

I wish your dad improved health and well-being. :)

He's lucky to have you on his team.