02/26/2024
Coronary artery bypass surgery opens up a new conduit for blood flow around a blocked or partially obstructed artery in the heart. The operation entails removing a healthy blood artery from the chest or leg. The vessel is connected beneath the clogged cardiac artery. The new connection increase blood flow to the heart muscle .This procedure does not treat the fundamental cause for blockage such as atherosclerosis or coronary artery disease. However, it can relieve symptoms like chest pain and shortness of breath. The operation, known as CABG, may lower the risk of heart disease-related death.
Why Is It Done?
Coronary artery bypass surgery is performed to restore blood flow to a blocked heart artery. If other therapies for a heart attack do not work, surgery may be performed as an emergency treatment.Your doctor may recommend coronary artery bypass surgery if you have:
- A blockage in the left major cardiac artery. This artery sends a large amount of blood to the heart muscle.
- A severe narrowing of the major cardiac artery.
- Severe chest pain caused by the constriction of multiple cardiac arteries. Even while at rest or in light exertion, the narrowing lowers blood supply to the heart.
- More than one damaged cardiac artery, and your lower left heart chamber isn't functioning properly.
- A clogged cardiac artery that cannot be repaired with coronary angioplasty. To enlarge the artery, this less-invasive therapy places a balloon at the tip of a narrow tube known as a catheter. A tiny coil known as a stent is commonly utilized to keep the artery open.
- An unsuccessful angioplasty, whether with or without a stent. For example, an artery narrowed again after stenting.
Risks
Coronary artery bypass surgery is an open-heart procedure. All operations include some risk. Possible complications of coronary artery bypass surgery are:
- Bleeding
- Death
- Heart attack caused by a blood clot following surgery
- Infection near the chest wound
- Long-term requirement for a breathing machine
- irregular cardiac rhythms, called arrhythmias
- Kidney issues
- Memory loss or difficulty thinking coherently, is usually transient
- Stroke
- The risk of problems increases if the surgery is performed as an emergency treatment.
- Your risk of problems following coronary artery bypass surgery is also determined by your pre-operative condition. The following medical problems raise the likelihood of complications:
- Blocked arteries in the legs
- Chronic Obstructive Pulmonary Disorder (COPD)
- Diabetes Kidney disease
How Do You Prepare?
Before having coronary artery bypass surgery, you may need to adjust your lifestyle, nutrition, and medications. Your healthcare professional offers you precise guidelines.
Arrange for someone to drive you home following your hospital stay. Make arrangements to have help at home while you recover.
What Can You Expect?
Before The Procedure
If coronary artery bypass surgery is scheduled, you are typically admitted to the hospital on the morning of the procedure. You have multiple cardiac tests and blood tests in the days and hours preceding surgery.
During The Procedure
Coronary artery bypass surgery is a major procedure that is performed in a hospital. Cardiovascular surgeons, or doctors who specialize in heart surgery, perform the surgery. Cardiologists, or heart doctors, work with a team of medical providers to care for you.
Before you enter the operating room, a healthcare practitioner puts an IV into your forearm or hand and administers a sedative to relax you.
When you are in the operation room, you can expect the following:
Anesthetics: You are given a combination of medications through an IV and a face mask. These medications provide a pain-free, sleep-like state. This is known as general anesthesia.
A breathing machine: A care provider places a breathing tube into your mouth. This tube connects to a breathing equipment known as a ventilator. The machine will breathe for you throughout and immediately after operation.
Heart-lung machine: During surgery, a heart-lung machine keeps blood and oxygen flowing throughout your body. This is known as on-pump coronary bypass.
Coronary artery bypass surgery typically takes 3 to 6 hours. The duration of operation is determined by the number of blocked arteries.
- A surgeon usually makes a lengthy cut along the center of the chest, following the breastbone. The surgeon spreads the rib cage to reveal the heart. After opening the chest, medication is used to momentarily stop the heart. The heart-lung machine is turned on.
- A healthy blood vessel is removed by the surgeon, most commonly from the inside of the chest wall or the lower leg. This bit of healthy tissue is known as a graft. The surgeon inserts the graft's ends underneath the obstructed heart artery. This opens up a new conduit for blood to flow around the barrier. Multiple grafts may be used during coronary artery bypass surgery.
- Coronary artery bypass surgery can be performed off-pump or with a beating heart.
- Coronary artery bypass surgery does not always need a heart-lung machine. Instead, the surgery is performed on a beating heart. Special machine is used to stabilize the portion of the heart being operated on. This type of surgery might be difficult because the rest of the heart is still active. It is not a possibility for everyone.
- Minimal invasive surgery. A heart surgeon performs the procedure via small incisions in the chest. Port-access or keyhole surgery are two terms that may refer to minimally invasive heart surgery.
- After the surgery, the health care personnel restore your heartbeat in the operating room and turn off the heart-lung machine. The surgeon uses wire to close the chest bone which last in your body after the bone heals.
After The Procedure
After coronary artery bypass surgery, a team of health care workers monitors you and ensures you are as comfortable as possible. You may feel sore and bewildered when you wake up. You can typically expect the following:
A breathing tube: The breathing tube remains in your throat until you are awake and able to breathe on your own.
Hospital stay: Expect to stay 1 to 2 days in a hospital's intensive care unit. The length of your hospital stay is determined by how well you heal and whether you develop complications. Some people who undergo coronary artery bypass surgery return home within a week.
Checks for heart rhythm and breathing patterns: Your health care team will closely monitor you following surgery to look for issues. Machines monitor your breathing and heartbeat. You have frequent temperature checks.
Medicines: Medicines are administered intravenously to relieve pain and avoid problems such as blood clots.
After surgery, especially even at home, you should keep an eye out for signs of problems. Call your doctor if you have:
- Fever.
- Rapid heart rate.
- You're experiencing new or worsening pain around your chest wound.
- A change in skin color near your chest wound.
- Bleeding or discharge from your chest wound.
It typically takes 6 to 12 weeks to recuperate from coronary artery bypass surgery. After 4 to 6 weeks, you should be able to drive, return to work or the gym, and resume sexual activity with the approval of your doctor. However, everyone recovers differently. Consult your healthcare provider for assistance.
Conclusion
Most people feel better after their coronary artery bypass surgery. Some people have been symptom-free for years. However, the graft and other arteries may get clogged in the future. If this happens, you may need additional surgery or procedures. Your findings and long-term prognosis are determined by how well you manage your blood pressure and cholesterol levels, as well as chronic illnesses like diabetes. It's critical to take your medications as prescribed. You can control and even improve your heart health by making changes in your lifestyle.