CORONARY ARTERY BYPASS GRAFTING

Heart bypass. This operation having rather complicated name is known among patients as heart bypass. This means to circumvent the narrowed section of the coronary vessel which was struck by atherosclerotic plaque. The operation is performed in cases where the coronary vessels of the patient are severely affected by the disease and there is a real risk of having a heart attack, meaning also potential death. If such narrowing or blockage is ascertained must be performed an operation for bypassing the site of clogging using a blood vessel taken from the patient.

CORONARY ARTERY BYPASS GRAFTING

How is the surgery done?

It is performed in the conditions of the so-called open heart. This means that the heart of the surgical patient is stopped and is not pulsing several hours. Heart must be enabled, after the necessary adjustments are made thereto, upon submitting a signal to start and to restore its vital functions i.e. to begin again to beat and contract and pump blood throughout the body. Once the cardiac muscle pump is operational the surgical patient starts its second life.

During the operation the surgical patient except that he does not have his own pulse is also with lower body temperature (hypothermia). This condition is achieved by using a machine for extracorporeal circulation. Special solutions, called cardioplegic, stop the heart. They have the ability to fully preserve the cells of the heart and its contractile ability so that after a short stay in complete rest for implementing the necessary corrections the heart may again start beating.

What is the percentage of risk?

Coronary artery bypass is considered as a routine operation. If the health condition of the surgical patient is not accompanied by comorbidities that may complicate the operation, the risk of death is less than 1 percent. When the disease of the heart is accompanied by certain other diseases such as cerebrovascular disease or renal failure, or disorders of the liver function, the risk is slightly higher - up to 2 percent.

What is the benefit from this surgery?

Practically after the operation the patients are healthy again. Their hearts are recovering and can work and live as full human beings. The material which is grafted to the heart in order to be circumvented the narrowing or blockage of the coronary artery is either the great saphenous vein (vena safena magna) which is taken from the lower limb of the patient or internal mammary artery (arteria mammaria interna) which is located in the thoracic cavity.

What is the guarantee that the disease will not be restored again regardless of the operation and how many years can a patient with a bypass graft survive provided that his heart has been working as one of a healthy person?

If he does not get sick from other diseases the duration of the trouble free period when no complaints are expected in about 70-80 percent of the surgical patients is 10 years. Such an operation reduces several times the risk of heart attack in the later life of the surgical patient. Reduces the risk of occurrence of arrhythmias by its beneficial effect on the life of the heart muscle. Most important for the prognosis is the patency of the bypass. It depends on many factors. Firstly, of what material the grafts were made. When it is a vein, the risk of clogging in the next ten years is greater than if it is patient's own artery.

For a long time, which is different for different people, in the chests of the surgical patients, especially at the places where the incision has been made and the area around it, they feel constantly stretching, pulling, tingling. This feeling intensifies especially in deteriorating weather and change of seasons when atmospheric conditions are worsening. These sensations are caused and related mostly to the slower healing of the sternum which is cut during surgery. It is secured with wire clamps around which later on are formed adhesions and precisely they cause unpleasant sensation of pain that has nothing to do with the anginal (suffocating) pain, so it should not scare the surgical patients.

Is it possible to be made a repeated bypass of a patient who has been once operated?

Yes, if the patient's condition due to one reason or another has deteriorated. It can be performed a second, even a third operation. The risk is higher than in the first time only because there have formed adhesions that interfere and make the surgery more complex.

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