Hard-Hearted Hannah Stalled.

Hello Hard Hearted Hannah,

I'm so sorry to hear about your diagnosis.

We don't have any information on our site about Chelation therapy, though there have been a few SharePosts on the topic.

This is a great question for our community and, especially, Dr. Davis. I will forward it on to him and ask if he would like to write a blog about alternatives to bypass surgery. 

Thanks for the post and please keep us updated on how you're doing!

Best wishes,

Katherine  

Hi:  I'm a cardiologist and I wanted to offer you hope about your occluded RCA.  Although I know you'd like to have a normal artery.  Most people can live quite well with an occluded RCA.

The right corornary artery is not as critical at the left sided arteries.  If your other arteries are open then you should be able to function well depending on how much damage was done to your heart.

Chelation has never been proven to work.  I've had some patients swear by it, but I've never seen that great of results myself. 

Following the Mediterranean Diet can be remarkably helpful.

take care,

Kirk Laman, D.O.,F.A.C.C.

http://blog.drkirklaman.com

You wrote:

". . . Seems logical that if there is no flow at all, then these therapies could not clean out the artery and wash the plaque away. There must be some flow. I wish that were somehow not true. Is my only possible treatment going to be by-pass surgery."

Angioplasty and stenting is not like fixing a plumbing problem where the clogged artery is "cleaned out" and the plaque is "washed away." Atheroslerotic plaques and blockages are systemic, and the fact that a section of a stenosis was opened in one artery doesn't "fix" the problem, at least not in the long run.

The angioplasty and stenting will relieve angina symptoms and restore the lumen (so long as there is no restenosis) which may allow you to begin to exercise without pain and to begin the rest of the lifestyle modifications and dietary changes,  as well as optimal medical treatments which will hopefully stablize your plaque, reduce your BP and cholesterol levels to target goals, and begin to get your body back in order and under control.

As for flow, the body often tends to compensate for blockages in coronary arteries by growing collateral arterial tissue to supply blood to your heart muscle (essentially a natural sort  of bypass).   There's some very exciting work being done in the field of angiogenesis, or the growth of arterial tissue in the heart and peripheral arterial pathways by a number of companies and research institutions, but for now much of it is considered experimental (if you're interested check out Cardium Technologies).

You ask about chelation therapy.  I have no real idea whether that sort of therapy should or shouldn't work with a 100% blockage of your RCA.    Bypass surgery is certainly a viable option, and probably would be considered by many to be a better option than trying to perform angioplasty on a very long lesion where multiple stenting would be required.   Ask your doctor about Mid-Cab (which is short for "minimally invasive cardiac artery bypass") surgery.  This is off-pump surgery in which a small incision only is made in the chest, and it avoids many of the general risks attendant to standard CABG (e.g., cutting the sternum).