Q: My mother is diabetic type II patient. Last year she was complaining of chest pain and when we got some stress tests done, they diagnosed that some part of her heart was not receiving oxygen. So they gave blood thinners like Lipanthyl and also advised her to take CedoCard only if she gets chest pain. We took her to hospital recently and did some overall routine tests and doctor suggested Angiogram. Now she has been advised to get Bypass Surgery done because they think she has 3 blockages in the coronary arteries and they think the blocks are significant. Is bypass necessary because has not been complaining of any chest pain for few months now? What are the risks for a 60 year old female with acute diabetes?

A:Right at the outset, let me tell you that its impossible to give definitive advise regarding bypass surgery without actually seeing the angiography film or having a detailed angiography report. However, going by the fact that she has got blockages in all the 3 major coronary arteries and these are long blocks, I think she would need some kind of intervention. Whether it is angioplasty or bypass surgery, depends on the coronary angiography findings. Lots of patients, especially if they are diabetics, do not complain of chest pain and they remain totally symptom free and the first presentation is heart attack which is a rather serious thing. It is therefore mandatory that these patients should undergo intervention and in your mother's case most probably bypass surgery, as the blockages are long and she is diabetic also. Regarding risks of coronary artery bypass surgery, now days we are doing almost 100% of surgeries without the use of cardiopulmonary bypass or heart lung machine and the risk in these patients have steadily come down. If the heart function is normal and there are no other complicating factors in the form of any damage or blockage of arteries of the brain, then the risk of surgery should be in the range of 1%. However, if the heart is damaged or there are other risk factors involved then the risk may proportionately increase.