Coronary Bypass Surgery
Your doctor can order a series of tests to determine the extent of your heart disease. Most likely coronary angiography will be required along with cardiac catheterization. With these attempts, x-ray images of your heart’s condition are taken. Depending on the degree of obstruction in your arteries, your doctor may recommend coronary artery bypass. This intervention corrects the blood flow that feeds the heart muscle and brings you back to a healthy heart. Coronary Bypass means a second chance for your heart and life.
Your heart is only the size of your fist. Nevertheless, it continuously functions as a pump and meets the blood needs of your entire body. The heart itself needs oxygen-rich blood to do this job. This blood is delivered to your heart through the coronary arteries.
Your heart depends on the blood offered by the coronary arteries to survive. The coronary arteries are the first branches of the aorta, the largest vein that distributes blood from the heart to the whole body. The left coronary artery and the right coronary artery divide into smaller branches, feeding the periphery around the heart.
Coronary artery bypass surgery allows the heart to re-supply blood by creating another pathway beyond the blocked or narrowed part of the artery. More than one bypass procedure is performed in case of more than one obstructed vessel.
The vessels to be used to bypass, or grafts, are taken from the chest, arm or leg and connected to the obstructed coronary artery. Frequently used grafts are from the internal thoracic arteries from the chest wall, radial arteries from the arm, and saphenous veins from the leg (these arteries and veins are sufficient for several bypasses). The areas where these veins are taken from are equipped with spare veins, so removing them does not affect the body’s blood flow.
How Is Coronary Bypass Surgery Performed?
The fact that bypass surgery is performed by a highly experienced team will make you feel safe. With the support of advanced technology, surgeons and specialists apply the safest surgical technique for you. Everyone involved in your surgical procedure plays a vital role. Cardiac surgeons and assistants receive support from specially trained nurses while performing the bypass procedure. An anesthesiologist constantly monitors your vital signs on the monitor to ensure a painless procedure. A perfusionist checks the heart-lung machine that provides blood circulation. All your parameters such as blood pressure, temperature and respiration are closely monitored while your surgeon connects the healthy vein with the heart.
Accessing the Heart
The surgeon makes an incision in the midline of the chest and separates the breastbone (sternum) to access the heart. After the surgery, the breastbone is reconnected with strong wires and the incision is sutured. In most cases, the breastbone recovers completely in 6-8 weeks.
Ensuring Blood Circulation
The heart can be temporarily stopped before the sensitive grafting procedure. Circulatory and respiratory functions are maintained by a heart-lung machine during this time. The machine supplies oxygen to the blood and pumps it back into the body. Your heart and lungs return to their former functions immediately after surgery is completed.
The vessel to be bypassed is taken from the chest, arm or leg. One end of the vessel is sutured to the coronary artery downstream from the obstruction. If a radial artery or saphenous vein is used, the other end is sutured to the aortic vein. If a thoracic artery is used, the other end is already connected to a branch of the aorta.
- Bypass surgery, including all stages from preparation to surgery, takes about 2-6 hours in almost every center. Plan some activities that will relax you while waiting.
- Remind yourself that this surgical procedure is performed by experienced people.
- Immediately after the surgery, your patient is taken to the intensive care unit (ICU). You will have the opportunity to see your patient in the ICU within a few hours after the surgery or in the evening. Intensive Care Unit staff will give you details.
- Prepare yourself to see your patient attached to monitors with many instruments around him. Your patient may appear pale, having difficulty breathing, and weak under the anesthesia. Do not forget that this is normal after surgery.
The patient will be taken to the Cardiac Intensive Care Unit (ICU) Immediately after surgery. Your recovery is monitored closely in this unit. Although the recovery rate is different for everyone, you will probably spend a few days in the intensive care unit. When you leave the intensive care unit, you will be transferred to another part of the hospital.
Intensive Care Unit
When you regain consciousness after surgery, you may feel tired, thirsty or cold. This is normal after this type of surgery and does not last long. Usually you will not feel pain. If you feel pain, nurses can give you medication for pain. Be ready to see that many tubes and cables are attached to your body during surgery.
In the beginning, you will be connected to the breathing apparatus through a tube in your throat. You can’t talk as long as this tube is in place. Chest tubes are also for the removal of leaks from the operation site, a heart monitor records your heart rate and a catheter is attached for urine output. Intravenous connections are placed during and after surgery to deliver fluid, medication and blood. These tubes and connections are removed when they are no longer needed (usually within 3-4 days).
During your stay in the hospital, a nurse or therapist will assist you with deep breathing and coughing exercises to prevent lung problems. Breathing exercises are essential for your speedy recovery.