Q: What is the best way to ensure that the grafts are fine 5 years after CABG? Is angiogram needed to check this?
A:The best way to keep fine after bypass surgery is to look after all the risk factors, which lead to blockages of the arteries of the heart. One should control the blood cholesterol levels by eating healthy diet and by regular exercises. The diet should not contain more than 30% of calories as fat and out of the total fat requirement 90% should be poly unsaturated fatty acids with 10% being made up by saturated fatty acids. In lay man term one should avoid butter on the table, should take cream free milk and cured should avoid deep-frying and in between meals snacks. Confectionery products like biscuits, cakes and pastries and snacks like samosa and bread pakoras are a big no. Fat coming out of vegetable origin is better than the fat coming from animal origin and olive oil is probably one of the better cooking media, though it contains cholesterol and is not totally safe. One should exercise for at least 20 minutes every day and 20 minutes of brisk walk is recommended preferably daily or at least 5 times a week. Also one should avoid both active and passive smoking, keep away from pollution, avoid stresses of life and if possible spend some time meditating or doing some yogic exercises or indulging in extra co-curricular activities which bring relaxation. Needless to say diabetics and hypertensives should keep their diabetes and hypertension under control. Weight control is also very important as we the ethnic Indians and south east Asians are very prone to obesity and with genetic predisposition to blockage of the arteries of the heart, we are at a special risk. In nutshell we need to have common sense approach to life and live life pragmatically and not be too obsessed with idealism or perfectionism so change of attitude to life and life style is what is warranted. Regarding your second query, is angiogram needed ? I don't think a routine angiogram is called for unless and until you have any symptoms suggestive of recurrence of disease in which case the angiogram may be mandated. I hope I have answered all your queries to your satisfaction, but if you have any further, please feel free to contact us.