Bob Caulkins,

Thanks for your question.

I'm unclear of a couple of factors.  Did you undergo a catheterization at this time?  Without cath, how were they able to quantitate the degree of occlusion of the left main? 

A lot also depends on what was done in 1981.  Are the bypass grafts still open?   Are there occlusions of the grafts?  Do these grafts bypass the occluded areas in the Right Coronary Artery (RCA) and the Circumflex?  Were the RCA and Circumflex occluded in 1981?

You will require a catheterization to exactly quantify any occlusions, in addition to visualizing the grafts that were placed in 1981.  If the 1981 grafts bypassed a previously occluded RCA and Circumflex, and the grafts are patent (open), this just leaves the 80% blockage of the left main.  Opening this up should put you back to where you were after surgery, assuming the above is true and the grafts are patent, with no new areas of disease that need to be addressed.  If the total blockage of the RCA and Circumflex is new and there are new areas of heart muscle deprived of blood flow, then more work has to be done.  Again, the cath would guide your doctor as to what exactly is required.

Without knowing more, this is the best I can do to answer your question.  I hope I was clear enough.

Best wishes. 

Martin Cane, M.D.