Brief Answer:
I would explain as follows:

Detailed Answer:

Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, about survival, I would explain that it will depend on several predictors.

Survival, as an expression of overall health is influenced not only by cardiac issues, but also by possible co-morbidities.

As you have experienced a previous heart attack, it is important to take into account the overall cardiac performance (has the previous heart attack decreased left ventricular ejection fraction and other indexes of contractility?).

A decreased cardiac performance is one of the main predictors of a compromised survival.

It is important to review you current cardiac ultrasound report for a professional opinion.

If left ventricular myocardial mass isn't substantially compromised, then it will not affect seriously your survival.

Another factor to consider is the long-term patency of your bypass grafts. Arterial grafts have higher chances for longer functionality than venous ones.
About half of venous grafts may become occluded by the end of a decade. So, you need to be alert if clinical symptoms suggestive of cardiac ischemia appear (a prompt treatment may obviate potential complications).

An optimal maintenance therapy and a healthy life-style and diet may help to maintain a longer positive result of your bypass procedure.

Remember that, bypass surgery is a therapeutic option, which resolves your coronary artery disease implication on myocardial metabolism and survival.

BUT. it will never change your metabolic profile, thus could never avoid your unfavorable continuing atherosclerotic process.

That's why preventive and therapeutic strategies are equally important when dealing with survival issues.

Co-morbidities play an important prognostic role, too.

If no obvious co-morbidities are present, then no adverse influence on survival may be added.

We have to take into account all the above mentioned factors to have a better understanding of what is expected to happen in the future.

Hope to have fulfilled your expectations for clarifying this issue.

Feel free to ask me whenever you need! Greetings! Dr. Iliri

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Brief Answer:
Bypass grafts may maintain their patency for several decades.

Detailed Answer:
Hello again!

I would like to explain that bypass grafts are applied exclusively to severely obstructed or totally blocked coronary arteries.

They may remain functional for a very long time (couple of decades).

As I said above, there are several factors influencing bypass grafts longevity. Just review carefully the above mentioned factors.

Regarding COPD, it is necessary to performing a pulmonary function test for identifying the degree of pulmonary function deterioration.

If there are no important pulmonary function implications; furthermore an appropriate therapy is maintained, then no substantial implication of such an issue may be expected on patient survival.

Wishing you a pleasant weekend!

Regards,

Dr.Iliri

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