Overview
Surgical Procedure :
To bypass the blockage, the surgeon makes a small opening just below the blockage in the diseased coronary artery. If a saphenous (leg) or radial (arm) vein is used, one end is connected to the coronary artery and the other to the aorta. If a mammary artery is used, one end is connected to the coronary artery while the other remains attached to the aorta. The graft is sewn into the opening, redirecting the blood flow around this blockage.
The procedure is repeated until all affected coronary arteries are treated. It is common for three or four coronary arteries to be bypassed during surgery. Before the patient leaves the hospital, the doctor or nurse will explain the specific bypass procedure that was performed.
Heart-Lung Machine :
During surgery, the heart-lung bypass machine (called “on-pump” surgery) is used to take over for the heart and lungs, allowing the circulation of blood throughout the rest of the body. The heart’s beating is stopped so the surgeon can perform the bypass procedure on a “still” heart
What happens during the cardiac bypass surgery ?
The surgery generally lasts from three to five hours, depending on the number of arteries being bypassed. After general anesthesia is administered, the surgeon removes the veins or prepares the arteries for grafting.
There are several types of bypass grafts that can be used in cardiac bypass surgery. The surgeon decides which graft(s) to use, depending on the location of the blockage, the amount of the blockage and the size of the patient’s coronary arteries.
After Surgery :
After the grafts have been completed during the “on pump” procedure, the heart-lung machine is turned off, the heart starts beating on its own, and the flow of blood returns to normal. Temporary pacing wires and a chest tube to drain fluid are placed before the sternum is closed with special sternal wires. Then the chest is closed with internal stitches or traditional external stitches. Sometimes a temporary pacemaker is attached to the pacing wires to regulate the heart rhythm until your condition improves.
The patient is transferred to an intensive care unit for close monitoring for about one to two days after the surgery. The monitoring during recovery includes continuous heart, blood pressure and oxygen monitoring and frequent checks of vital signs and other parameters, such as heart sounds. Once the patient is transferred to the nursing unit, the hospital stay is about 3 to 5 more days.
Recovery :
Full recovery from coronary artery bypass graft surgery takes around two months. Most patients are able to drive in about three to eight weeks after surgery. Your doctor will provide specific guidelines for your recovery and return to work, including specific instructions on activity and how to care for your incision and general health after the surgery. Coronary artery bypass graft surgery does not prevent coronary artery disease from recurring, therefore lifestyle changes and prescribed medications are strongly recommended to reduce this risk.
Lifestyle changes include : -
- Quitting smoking
- Treating high cholesterol
- Managing high blood pressure and diabetes
- Exercising regularly
- Maintaining a healthy weight
- Eating a heart-healthy diet
- Controlling stress and anger
- Taking prescribed medications as ordered
- Participating in a cardiac rehabilitation program, as recommended
- Following up with your doctor for regular visits
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