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Pain in arm after TRIPLE BYPASS surgery. STENT.

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I am due for a stent very soon after a triple bypass which I did on the 3rd of Jul 2013, I keep feeling pain in my left arm, I did a cath and the results of after and before can be seen here:
Unzip the file, start autorun and select source from after and before, otherwise, you can use your own dicom viewer for the images,

Is it possible that you give me at least a hint whether I should really go for the stent or should seek another opinion?

Link for the TripleBypass report

Category: Cardiologist

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Category: Cardiologist
 26 Doctors Online

Thank you for your query at and my sincere apologies for the delay with replying to your consult.

I have seen your angiographies. Your surgeon should have done grafting of the High OM vessel and Ramus at the time of bypass surgery. He could also have tried grafting of the diagonal artery at that time. The lesions in these arteries have progressed and may probably be causing the left arm pain on exertion. I dont see any suitable area for stenting. If your cardiologist wants to stent LCX he will end up giving competitive flow in the Graft to OM as there is no significant lesion in OM itself. Also the distal LCX receives blood flow from the OM graft. There is a lesion of about 60 percent in distal LCX just at the OM bifurcation. But that is not significant enough to merit stenting. Also the lesion mat be appearing more than it actually is due to competitive flow from OM graft. Medical therapy would be best forr the OM Ramus and diagonal lesions.
Hope this helps, please feel free to discuss further.
Dr Vivek Mahajan
DM Cardiology (PGIMER)
MD Medicine (AIIMS)

Dr. Vivek Mahajan
Category: Cardiologist
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
Dr. Vivek Mahajan and 4 other Medical Specialists are ready to help you

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