<s>[INST] sir my grandmother had one attack & had angioplasty.but for again block appeared on the same place where surgery had done.Her heart is weak also.She has respiration problem also.For one month she is hospital in ICU.she has 75 year old.So what is the solution.weight 70 kg.she has pressure & sugar problem. [/INST] Hias per you she has already been stented once , and the stent is showing rethrombosis , considering her age the best possible solution is Minimally invasive coronary artery by pass surgery,as her left ventricle ejection fraction is also low as said by you , MICAS is a good alternate for her, in long run it will improve her cardiac functions also , and  its almost non invasive unlike open heart by pass surgery.unlike conventional surgery, which has a 10"-12" incision and places the patient on the heart-lung machine, new minimally invasive approaches may avoid placing the patient on a heart-lung machine, and can be performed through a 3"-5" incision placed between the ribs, or may be done with several small incisionsbenifits are-Shorter length of stay:Faster recovery: Avoidance of the heart-lung machine and the use of smaller incisions may reduce the risks of complications such as stroke and renal failure so that patients can return to their normal activities in 2 weeks rather than the typical 6 to 8 weeks with conventional surgery.Less bleeding and blood trauma: Any time blood is removed from the body and put into the heart-lung machine, the patient must be put on anticlotting medications or given "blood products". Artificial circuits such as the heart-lung machine can also damage blood cells. These factors may affect the blood's ability to clot after surgery. Avoiding the heart-lung machine can alleviate this blood trauma.Lower infection rate: A smaller incision means less exposure and handling of tissue, which may reduce the chances of infection.Available to more patients: Some patients are poor candidates for traditional bypass surgery because their illness is too widespread, their heart is too weak, or because they will not accept blood products. Some patients are able to receive this life-saving surgery through minimally invasive techniques.Less cost: The cost of minimally invasive cardiac surgery may be approximately 25% less than the cost of conventional surgery.You can consider the option of micas </s>