Q: What is the prognosis in triple vessel heart disease? I have had a bypass surgery and I have a 100% blockage in the LAD again and 2 other major blockages including the left circumflex. My doctor is treating me medically and all my grafts were done with the sapheneous vein. I am a chronic myelegenous leukaemia patient in remission on interferon long term. Please advise.

A:Prognosis in coronary artery disease is dependent on multiple factors like the symptomatic status, function of the heart, the status of the valves, nature of the block - that is whether it is localized or generalized, pressures of the lung and so and so forth. Therefore to give an exact answer to your question on prognosis of triple vessel heart disease, is not feasible. In general terms, however, if the patient has got triple vessel coronary artery disease that involves the proximal segment of the LAD and if the patient is symptomatic or the heart function is weak, then the results of medical management are inferior than the results of surgical management. Therefore, unless there is any other limiting reason as far as the life span an of individual is concerned, redo surgery is strongly indicated. In your case, if your chronic leukaemia is in remission and if the concerned doctor feels that leukaemia is not an immediate problem, then I suspect you will be better off undergoing redo bypass surgery. However, all this advise is given based on the report that you have submitted and I think better advise can be given by the physician or cardiologist attending on you who has the benefit of seeing you first hand.