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April 9, 2005

Complications, Other

Question from Charlotte, Nort Carolina, USA:

My mother had a catheterization done today and the doctors determined that she has two major blockages and a whole in her heart (how big, I don't know). Their suggested course of action is a triple bypass. She has to wait at least a week because she has to get the Plavix, for high blood pressure, out of her system. My twin sister also has type 1 diabetes, and is very distraught about mom having this surgery. I, too, am worried because I know this is a very precarious operation. What I don't know are statistics, specific risks, etc. Can you please enlighten me so I can be more informed about this procedure? I don't want to ask my mother for fear of adding more stress and worry to her.

Answer:

Plavix is a medication that prevents blood clots. It needs to get out of her system to prevent severe bleeding. The procedure should be looked at in terms of a risk-to-benefit ratio. I know that sounds too clinical and too sterile. However, there is an up and down side to doing the procedure and an up and down side to not doing the procedure. In the big picture, if the blockages are severe and put her at increased risk of a heart attack or even death, the surgery would have the immediate effect of decreasing her risk of dying from a heart attack. Without the specifics, I cannot comment on the absolute risk. If she doesn’t have the surgery, it is possible she could develop a heart attack, severely damage her heart and die. Then, you would be left saying “we could have done something.” Your doctor can speak with you about the risks, the benefits, and their recommendations. Sometimes, the immediacy of the problem is what is really upsetting. Having to contemplate a major surgery with very little advanced warning is very troublesome. Sometimes that is more the issue than the actual decision itself.

JTL