Coronary artery bypass surgery is a surgical process used to treat coronary artery disease. Coronary artery disease is a problem in the heart usually caused when the blood vessels narrow, and there is difficulty in supplying blood, oxygen, and nutrients to the heart. This disease is generally caused due to build-up of fatty material in the wall of arteries. In coronary artery bypass surgery, the doctors will replace the blocked portion of the coronary artery with a healthy vein. This vein may be a part of your leg or an artery from your chest. The doctor will replace the vein with the blocked artery, and the blood will quickly be passed from that artery to the heart muscles. This whole process is known as coronary artery bypass surgery.
Purpose of coronary artery bypass surgery:
Coronary artery bypass surgery is not the only treatment option if a person is diagnosed with blocked arteries. The doctor may suggest this surgery in the following cases:
- If you are suffering from critical chest pain due to the narrowing of arteries in your heart that cause a shortage of blood in muscles even after light exercise
- If the left ventricle, which is the main pumping chamber of the heart, is not functioning well
- If your arteries supply more blood to the left ventricles due to narrowing or blockage of the arteries
- Suppose you have artery blockage that is unable to treat through angioplasty. Angioplasty is a technique in which doctors insert and inflate a tiny balloon to widen the arteries.
- If you undergo stent placed procedure, but arteries get narrow again
This surgery is only performed in emergencies such as heart attacks if the disease cannot be treated through other treatments.
Before the surgery:
- Before surgery, your doctor will conduct a complete physical trial, including blood tests and diagnostic tests, to clarify that you are ready for surgery.
- Tell your doctor immediately if you are pregnant or expected to be.
- Discuss the medicines and supplements your doctor that you are taking at that time
- Let to know your doctor if you are allergic to latex, iodine, or anesthetic medication.
- Ask questions to your doctor regarding the procedure of surgery.
- Usually, you are asked to drink eight glasses of water before the surgery.
- Discuss with your doctor if you have any bleeding disorder or taking any blood-thinning medicines
- Let to know your doctor if you have any implanted cardiac device or pacemaker in your body.
- You will get a consent form before surgery; read it carefully and ask if you have any questions.
During the surgery:
It takes three to six hours to perform coronary artery bypass surgery. The number of bypasses you can take usually depends on the location and severity of the disease.
- During surgery, a breathing tube is inserted into your body through your mouth for general anesthesia. The breathing tube inserted in your mouth is directly attached to a ventilator that helps you breathe during or after surgery.
- Many coronary artery bypass surgeries are performed through a long incision in the chest. A heart-lung machine helps blood oxygen flow in the whole body during surgery; this process is called on-pump coronary artery bypass surgery.
- Then the surgeon cuts down the chest from the center along with the breast bone and then opens the rib cage to reach your heart. When your heart is fully exposed, your heart will stop temporarily with the help of medications, and instead of a heart, the heart-lung machine helps to circulate the blood throughout the body.
- After that, the surgeon takes a healthy vessel, usually from your lower leg or inside your chest wall, and replaces the blocked artery with that healthy vessel so that blood flows easily without restriction.
- After completing the procedure, the surgeon will restore the heartbeat and disconnect the heart-lung machine from your body. Then the surgeon will close your chest at the end with the help of a wire which remains in your body until your bone heals.
Other surgical techniques:
Two crucial surgical techniques used by many surgeons are the following:
- Minimally invasive surgery: In this procedure, the surgeon will perform a small incision in the chest and, with the help of video imaging and robotic surgeons, operate in the small area. Keyhole surgery and port-access surgery are some variations of minimally invasive surgery.
- Off-pump or beating heart surgery: In this surgery, the surgeon will perform surgery on a beating heart with the help of special equipment. This kind of surgery is tricky because stabilizing the targeted area with a beating heart is challenging.
After the surgery:
You have to spend a day or two in ICU after your surgery, and the breathing tube remains in your throat until you can breathe on your own. An exercise and lifestyle program, known as Cardiac rehabilitation, will be given to you to educate you on how to recover and maintain your health at home. If the situation remains good, it is expected that you will be discharged from the hospital within a week. You may face difficulties in everyday tasks or walking a short distance, but after four to six weeks, you may return to your routine. Contact your doctor if you feel symptoms such as fever, pain in the chest, bleeding in your chest, or rapid heart rate after the surgery.
Many people recover after surgery and remain healthy for more than 10 to 15 years after surgery. Over time or due to growing age, the patient might face clogs in the bypass, which may require another bypass or angioplasty.
Coronary artery bypass is open heart surgery with serious complications during or after surgery. These complications may include:
- Kidney problems
- Blood clots that cause significant health issues
- Heart attack
- Infection in the incision site
- Bleeding during or after surgery
- Loss of memory or trouble in thinking after surgery that improves after 6 to 12 months
- Chest wound infection
There is less chance of complications in your body, but it depends on your overall health. There is a greater chance that the situation gets complicated if you already have diabetes, emphysema, kidney disease, or blocked arteries in the legs.
The long-time results of surgery usually depend on the patient’s overall health and some significant lifestyle changes. To prevent further surgeries patient must have taken the following necessary steps:
- Take medications on time,
- lower your cholesterol, reduce your diabetes and control your blood pressure.
- Manage your stress
- Maintain a healthy weight
- Follow a healthy diet plan
- Exercise regularly
- Stop the use of smoking and alcohol