Coronary Bypass Surgery

1 What is a Coronary Bypass Surgery?

Coronary bypass surgery is a surgical procedure used to improve the blood flow to the cardiac muscle. This is achieved by creating a new pathway to the heart.

During coronary bypass surgery, a healthy blood vessel is taken from or your leg is or chest and is connected to other arteries in your heart so that blood bypasses the blocked area.

Following coronary bypass surgery, symptoms such as chest pain and shortness of breath due to poor flow of blood to the heart, generally improve.

In some individuals, the risk of dying of heart disease can be reduced and their heart function can be improved.

2 Reasons for Procedure

Here are the most common reasons to undergo a coronary bypass surgery.

You and your doctor will carefully consider whether coronary bypass surgery or another artery-opening procedure, such as angioplasty is the best for you.

Coronary bypass surgery is an option in the following cases:

If you have severe chest pain that caused by narrowing of several of the arteries that supply your heart muscle, leaving the muscle short of blood during even light exercise or at rest.

In some cases, angioplasty and stenting will be helpful, but for some types of blockages, coronary bypass surgery may be the best option.

You have more than one diseased coronary artery and the heart's main pumping chamber, the left ventricle is not functioning properly.

Your left main coronary artery is severely narrowed or blocked. This artery is responsible for supplying most of the blood the left ventricle.

You have an artery blockage for which angioplasty is not considered a possible option, you have had previous angioplasty or stent placement that has not been successful, or you have had stent placement, but the artery has narrowed again (restenosis).

Coronary bypass surgery may also be performed in emergency situations, such as a heart attack in case you are not responding to other treatments.  

Coronary bypass surgery does not cure underlying heart disease that caused blockages to begin with. This disease is referred to as atherosclerosis or coronary artery disease.

Even if you have coronary bypass surgery, lifestyle changes are still a necessity after surgery.

Medications are routine after the surgery to lower your blood cholesterol, reduce the risk of developing a blood clot and help your heart function as efficient as possible.

3 Potential Risks

Because coronary bypass surgery is an open-heart surgery, there are potential risks during or after your procedure.

The following are possible complications of coronary bypass surgery:

  • Bleeding. Heart rhythm irregularities (arrhythmias).
  • Infections of the chest wound. Memory loss or troubles with thinking clearly, which often improves within six to twelve months.
  • Kidney problems.
  • Stroke.
  • Heart attack, if a blood clot breaks loose soon after surgery.

Your risk of developing complications is generally low but depends on your health before surgery. Your doctor can give you a better idea of the likelihood of experiencing these risks.

Medical condition, such has emphysema, kidney disease, diabetes or blocked arteries in your legs peripheral artery disease (PAD) or operating in an emergency setting can also increase the risk of complication.

4 Preparing for your Procedure

In preparation for coronary bypass surgery, your surgeon will give you particular instructions about any activity restrictions and changes in your diet or medications you should follow prior to your surgery.

You will need a number of pre-surgical tests, often including blood tests, X-rays, an electrocardiogram and a coronary angiogram.

A coronary angiogram is a special type of X-ray procedure that makes use of dye to visualize the arteries that feed your heart. Most individuals are admitted to the hospital the morning of the surgery.

Coronary bypass surgery can also be performed in emergency situations, such as after a heart attack. Be sure to make the necessary arrangements for weeks after your surgery.

It usually takes a period of about four to six weeks for you to recover to a point where you can resume driving, return to work and perform daily chores.

5 What to Expect

Read on to learn more about what to expect before, during, and after your coronary bypass surgery.

During the procedure. The overall time to complete this procedure is between three to six hours and is done under general anesthesia.

The number of bypasses required depends on the location and severity of the blockages in your heart.

Most coronary bypass surgeries are done through a long incision made in the chest while blood flow is diverted through the heart-lung machine (called on-pump coronary bypass surgery).

The surgeon then cuts down the center of the chest along the sternum (breast bone). He or she will then spread open the rib cage to expose the heart.

The heart is the temporarily stopped and a heart-lung machine takes the offer to circulate the blood around the rest of the body.

The surgeon then takes a section of a healthy blood vessel, often from inside the chest wall (the internal mammary artery) or from the lower leg and proceeds to the ends above and below the blocked artery so that blood flow is diverted (bypassed) around the narrowed portion of the diseased artery.

There are other surgical techniques your surgeon can apply if you are having a coronary bypass surgery including of pump or eating-heart surgery.

This procedure is done on the still beating heart with the use of special equipment to stabilize the area of the heart the surgeon is paying surgical attention to.

This type of surgery s difficult to perform because the heart is still moving, because of this, it cannot be performed on anyone. Minimally invasive surgery.

A small incision is made through which the surgeon performs the procedure. He or she often works with the assistance of robotics and video imaging that makes sure that the surgeon can operate in a small area.

Variations of minimally invasive surgery may be called port-access or keyhole surgery. After general anesthesia has started, a breathing tube will be inserted through your mouth.

This breathing tube is attached to a ventilator, which does the breathing for you during the operation.

After the procedure. You must expect to a day or two in the intensive care unit after coronary bypass surgery as it is a major operation. Here, your heart, blood pressure, breathing and other vital signs will be continuously monitored.

Your breathing tube will only be removed when you are awake and able to breathe on your own.

Barring any complications, you will likely be discharged from the hospital within one week, although even after release, you may find it difficult to perform everyday tasks, or even walk a short distance.

If after returning home, you experience any of the following signs and symptoms, call your doctor immediately.

They could be indications that your chest wound is infected:

  • Fever.
  • Rapid heart rate.
  • New or worsened pain around your chest wound.
  • Reddening around your chest wound or bleeding or other discharge from your chest wound.  

A recovery period of six to twelve weeks must be expected. In most cases, you can return to work and resume full sexual activity after four to six weeks, but make sure you have your doctor's OK before doing so.

6 Procedure Results

Understanding the results of your coronary bypass surgery will be made possible by your doctor.

The majority of individuals who undergo coronary bypass surgery feel better and may remain symptom-free for as long as 10 to years.

However, with time, it is likely that other arteries or a new graft used in the bypass will become clogged. If such occurs, another bypass or angioplasty will be required.

Although bypass surgery improves blood flow to the heart, it does not have the ability to cure underlying coronary artery disease.

Your results and long-term outcome will depend on taking your medications to prevent any blood clots, lower blood pressure, and lower cholesterol and help control diabetes as directed, and also following the following healthy lifestyle choices:

  • Stop smoking.
  • Maintain a healthy eating plan, such as the DASH diet.
  • Maintain a healthy weight.
  • Manage stress.
  • Exercise regularly.

Apart from making lifestyle changes, your doctor will also recommend a cardiac rehabilitation program.

Also known as Cardiac rehab, cardiac rehabilitation is a program of exercise and education, designed to help you during the recovery process after a heart attack, from other forms of heart disease of after surgery to treat heart disease.

Cardiac rehabilitation often begins while you are still in the hospital, it then continues with monitored programs in an outpatient setting until home-based maintenance programs can be followed.

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