Q: My 51 years old father underwent bypass surgery (CABG) eight years back. He is also suffering from diabetes and hypertension. Two years back, he had CT angioplasty, which reflects that 2 out of 3 grafts are again blocked however his main artery - Left Anterior Descending (LAD) is OK. The doctor has asked him to undergo angiography. Does my father need to undergo angioplasty?

A:CT Angiography is not a gold standard and it has got sensitivity and specificity to the tune of about 95% and therefore it is very important that we do cine angiography to the know the exact status of the arteries. If the patient is totally without symptoms and he is able to carry on with his normal day to day activities, then some times, especially if the LAD artery is open and flowing well, these patients can be managed on medical treatment also. The decision to go for bypass surgery or angioplasty depends on the angiography findings. If the LAD is flowing well, then angioplasty is a very reasonable option for the back of the heart and right sided arteries, but if LAD is also compromised, then surgery may be a better option. All these are theoretical considerations and once the coronary angiography is performed, your treating cardiologist will be able to discuss all options with you and give you a definitive answer as to what is in the best interest of the patient.