How long do drug eluding stents work???

How long do they normally function before complications (colapse, restenosis, narrow, etc) after that is it open heart surgery?? I have 2 PROMUS stents in my RCA mid and distal, and they are long. I know they don't last forever... So why would my Cardiologist tell my husband " the procedure was gorgeous, now i can tell you she might even die of something else? I don't want to get my hopes up, you know? My EF is 60% is that ok?

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Hey, you have a *great* ejection fraction (EF)! :) Most medical people will tell you that an EF between 50 and 70 percent is normal, so at 60%, you're right in the middle of the normal range. Last time I asked, my cardiologist told me mine was 55%. The Cleveland Clinic, one of the best heart centers in the country, has a good page explaining EF:
http://my.clevelandclinic.org/heart/disorders/heartfailure/ejectionfraction .aspx

Mayo does too, of course: http://www.mayoclinic.com/health/ejection-fraction/AN00360

I have six Xience V drug-eluting stents in my RCA (mid-, distal and proximal--basically they almost had to stent the whole thing because it was dissecting). When my husband and I asked about how long they lasted and when they might need to be replaced, we didn't get a solid answer.

Part of it is that the drug-eluting stents are so new, there just aren't many long-term studies on them.

We asked how we would know they would need to be replaced, and my doctor told me that I would start feeling the same symptoms that brought me to the ER.

I would much prefer to be able to say, "OK, I know that 10 years from now, I have to schedule another cardiac cath and have my stents replaced," you know, just like regular car maintenance--time for the ol' 10,000-mile stent check-up--but it apparently doesn't work like that.

Meanwhile, I'm trying to just follow my cardiologist's best advice on avoiding restenosis--he's kept me on Plavix and aspirin since my stents were put in just over two years ago--taking my meds, living a healthier lifestyle, and not stressing over what I can't change and can't predict.

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Oh my I haven't gotten a solid answer still and that makes me scared. I've been having chest discomfort, but it's supose to be muscular and anxiety. He told me that as long as I don't feel pain like when he put the stents in I should be fine. He also said "you'll know" ( since there so long) . I moved recently from out of the US... Do you think Mount Sinai Heart Institute is a good Hospital??? Is there better treatment at clevland clinic, mayo or any other? Do they have newer treatments like adult stem cell to repair damaged heart? Is your Dr. Going to keep you on aspirin an plavix forever? I recall he told me 3 or 4 months of 325mg aspirin, plavix for a year and baby aspirin for life. I've heard other keep taking plavix I' m scared to leave it. Is 70% EF better than 60%? Does mean I lost %? thank you for answering back, God bless u!

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US News & World Report recently came out with their yearly rankings of hospitals, broken out by specialty; this is their page for the top-rated heart centers in the US:

http://health.usnews.com/best-hospitals/rankings/heart-and-heart-surgery?pa ge=1

Cleveland Clinic is #1 on the list, and Mayo comes right behind them at #2. If you check the hospitals' websites, they should be able to tell you about which cutting-edge therapies and technologies that they have available.

Mount Sinai Heart Institute's scorecard from US News & World Report is here: http://health.usnews.com/best-hospitals/mount-sinai-medical-center-6390640/ heart-and-heart-surgery

When I saw my cardiologist back in January, he said the plan was to keep me on Plavix and an 81-mg aspirin for as long as I was tolerating them well, and aside from some menstrual issues, I mostly have been. Since I have so many stents, I wouldn't be surprised if he wants to keep me on Plavix and/or aspirin for the rest of my life.

I don't know if "better" is the right word for describing the normal range of ejection fractions--I mean, we're all trained that the bigger number is usually better, right? But in this case, it seems that the percentages 50% to 70% describe an acceptable range of what's considered normal.

I'm not sure if there's a way to know if yours is lower now than it used to be, unless you had it measured before your heart event. At 60%, I'd agree with your doctor that you have a great EF, well within the expected range.

I'm not a doctor, so I don't know what's causing your chest discomfort, but I can tell you about my own experience after having six stents and being in the hospital for a week: I was definitely experiencing a fairly high level of anxiety for the first couple of weeks after I got home. This played out as me worrying myself to distraction about every single slight twinge of pain in my chest, that beforehand, I would've just ignored. I was so scared and freaked out that two days home from the hospital, I made an appointment to see my regular doctor, and she was able to get me in to see my cardiologist much sooner than the initial six-week follow-up that had been set up when I was leaving the hospital.

When I saw my cardiologist at that visit, he had me show him where the pain was, and he had me describe it to him. He was very good about listening to me, and didn't get frustrated when I started crying. He did tell me that he was almost certain that what I was experiencing was anxiety, and that it was a normal reaction, given what I'd just been through.

The first couple of weeks home from the hospital were the worst for me, in terms of anxiety. Eventually I had to stop researching things online, stop reading about SCADs, stop looking at websites about stents, etc. I just couldn't take it all in, and it was leading to more stress, not less.

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Hi,
I just wanted to throw in my two cents and share some of my experience. I have 6 drug-eluding stents; 4 are Boston Scientific, the 5th and 6th are each different brands. My stents have been placed three different times due to dissection, so my experience is definitely different than yours if yours were placed during open heart surgery.

But there are many similarities I think... I had quite a bit of chest discomfort for a month or so after each time I had stents placed (mine were all done between April 2009 and April 2010). I personally believe that whenever doctors go in and "ding around with" our hearts and arteries, it takes a bit for the body to recover. So, I think discomfort is to be expected; to be mindful of it is a very good thing.

Each woman I can recall talking with about their heart attack or heart event describes re-occurances as having the same or similar symptoms, so I think it's reasonable to think that if you have another heart attack or blockage it will feel similar to your first time. Any doubt, call 911.

I was referred out to Mount Sinai in NYC to see a certain vascular doctor named Jeffrey Olin. I thought he was excellent and he works in their heart & vascular center. Whether they offer the best cardiac care, I can't say. But I was pleased with him, for sure. I live in Minnesota and he is following my care with my doctor from here.

Lastly, about your EF, I think it's great too :-) Mine is about 60% as well and I've been told that it varies throughout the day and on any given day. It is a measure of the heart's ability to pump blood in and out. My cardio also said it is a measure of heart function -- if the EF is that high, it means the heart functions normally. That's good news! With the stents and repairs made, your heart can function normally.

Whether the stents last a certain amount of time, I've not been given a direct answer either. But my doctors have said that if stents are going to re-stenos, they tend to do so within the first 6 months (they may say that since I've passed the 6 month mark though... LOL!!). The body is getting is getting used to the stent, and tissues can grow in through the stent walls at first.

I wish you well! Sounds like you have a positive attitude and that's awesome. Take care,
Jennifer

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