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Heart Bypass Surgery

WHAT IS HEART BYPASS SURGERY?

Bypass surgery is the most common type of surgery that is performed by the heart surgeons every year. It is also known as the coronary artery bypass surgery. Which aims to replace the coronary artery (blocked or damaged). Function of coronary artery is to supply oxygenated blood to the heart. When there is a restriction in the blood supply to the heart, the heart will not be able to function properly leading to heart failure.

 

 WHY IS HEART BYPASS SURGERY PERFORMED?


Need for Bypass SurgeryBypass surgery is performed to improve the blood flow of the heart which is has been blocked by plaque (atherosclerosis) or blood clots. The surgery involves taking a piece of (artery or vein) from somewhere else in the body and creates an alternative route or a bypass through the blocked area of coronary artery.

 

 

Human heart

 

Human heart is one of the major organ of the body. Its function is to pumps blood throughout the human body by a circulatory system. Chief function of the circulatory system is to pump oxygenated blood and nutrient in the body and remove carbon di oxide from the blood.

Parts of the heart-

 

  • Arteries- It is that blood vessel which carry the blood away from the heart.

  • Vein- It is that blood vessel which carried the blood back to the heart.

  • Aorta- It is the largest artery in the body whose primary function is to carry oxygenated blood from heart to the tissues.

  • Right atrium- This part of the heart is supplied with deoxygenated blood from different parts of the body.

  • Pulmonary veins- It carries oxygenated blood from lungs to left atrium.

  • Left ventricle- It receives blood from left atrium and pumps oxygenated blood to different parts of the body.

  • Mitral valve- It is located between left atrium and ventricle.

  • Tricuspid valve- It is a valve which is located between the right atrium and left atrium.

  • Right ventricle – The chamber of heart that pumps oxygen poor blood to the lungs.

  • Left pulmonary artery- It carries poor oxygen blood from right ventricle to the lungs. 

 

Working of a heart

In human the left and the right side of the heart works simultaneously.

Working Of a Human Heart

 

Right side of the heart –

  • The oxygen poor blood enters the heart (right atrium) through the inferior and superior vena cava.

  • When the right atrium contacts the blood moves from right atrium to the left ventricle through the tricuspid valve.

  • When the ventricle is full with blood from right atrium the right atrium, the tricuspid valve shuts to prevent back flow.

  • Now when the left ventricle contracts the bloods leaves the heart through the pulmonic valve into the pulmonary artery to the lungs where it is oxygenated.


 

Left side of the heart-

  • Pulmonary vein empties the oxygen rich blood into the left atrium from the pulmonary vein.

  • The left atrium contracts the blood flows from the left atrium to the left ventricle mitral valve.

  • When the ventricle is full the mitral valve shuts and prevents backflow.

  • Now, as the ventricle contracts the blood leaves the heart to the aorta via aortic valve to different part of the body


 

HEART PROBLEM MOST COMMON SYMPTOMS

Common Heart Problems
 

Who needs a bypass surgery

 

Bypass is done for the following reasons:-

  • Plaque: which is a component of blood builds up in the artery and blocks the way. This reduces the blood flow in the heart so the heart muscle is more likely to tire or fail. This causes failure in the left ventricle which is known as the main pump of the heart.

  • Coronary artery disease or atherosclerosis- If the coronary arteries become narrow or constricts so there is an increased chance of fatal heart attack.

  • When the blockage is too grave to be managed by medication (beta blockers) or other alternative treatments (balloon angioplasty).

  • Severe cad- This condition involves clogging of arteries by fatty deposition which reduces blood flow.


 

Method of diagnosis-
 

  • Physical exam- health professional may examine arteries for a whooshing sound called “bruit” with a stethoscope and also check the pulse.

  • Blood test- check the level of certain fat, cholesterol, protein and sugar in the blood. There abnormal level might put one to risk of arthrosclerosis.

  • Ankle/branchial index- it compare the blood pressure in your ankle with the blood pressure in your arms.

 

                                                                    Key Examination

Electro Cardio Gram (ECG)

Electro

Echocargiography
Stress TestingAngiography
 

 

 

 

PROCEDURE


BEFORE THE SURGERY

  • Prior to the surgery the surgeon will run several eye tests which will determine whether the candidate is fit for surgery or not.

  • Inform your doctor about what drugs are you taking.

  • For about 1 week prior to the surgery you may be asked to stop taking drugs that reduces the chances of blood clothing for e.g. :ASPIRIN ,IBUPROFEN ,NAPROXEN.

  • One should stop smoking.

  • Inform your doctor if you have fever, flu, herpes breakout or any other illness.

One day before the surgery-

  • The patient is asked not to eat or drink anything after midnight the night before.

 

DURING SURGERY
 

  • Surgery is performed under General Anesthesia.

  • Once unconscious an 8-10 inch long incision is made in the middle of the chest.

  • This will separate the breastbone to create an opening through which the heart and aorta can be easily seen.

  • Most of the people who are undergoing bypass surgery are connected to a heart lung bypass machine or bypass pump. The heart stops functioning while it is connected to this machine and the machine performs the work of the heart and lung, while the heart is undergoing surgery.

  • Pump coronary artery bypass: This is also a type of bypass surgery which does not require the bypass pump and is performed while the heart is still beating. In this an artery or a vein is taken from any other part of the body to make a detour or a graft around the blocked area. Grafts can be taken from saphenous vein from the leg, internal mammary artery (IMA), or most commonly radial artery.

  • After the graft has been created, the breastbone will be closed with the help of wires which will stay inside.. The surgical cut will be closed by stitches.

  • The entire surgical procedure takes 4 to 6 hours after that the patent is shifted to intensive care unit.

 

AFTER THE SURGERY

  • Patient is hospitalized for another 3-7 days.

  • Tubes will be fitted around the heart to remove the fluid around the heart.

  • The patient will have a catheter and intravenous line attached to the body. Machine will be attached to the patient to monitor temperature, blood pressure and breathing.

  • It takes around 4 to 6 weeks for a complete recovery.

 

Before and After Bypass Surgery

 

 

RECOVERY

The patient will be out of the bed in a day or two and can go home in a week. Full recovery will happen after two to three months depending on the fitness, age and the severity of the problem.

 

COMPLICATIONs

 

  • Infection- This includes chest wound infection (generally in case of obese or diabetes).

  • Heart attack

  • Stroke

  • Kidney failure

  • Lung failure

  • Depression and mood swings

  • Heart rhythm problem

  • Memory loss


 

PROGNOSIS

  • Most of the patients who have heart bypass surgery, the graft stays open and works well for many years.

  • The surgery does not prevent the blockage from coming back. But a person can do various things to slow down the process like not smoking, eating healthy diet, regular exercise, controlling blood sugar and treating high blood pressure.


 

ADVANTAGES – bypass surgery

 

  • Better long term survival rate

  • Lowers the risk of heart attack

  • Patient can live symptom free for as long as 10-15 years

  • Reduces chances of heart Failure

  • Excellent relief from angina and improved quality of life


 

Alternative names
 

  • Off Pump Coronary Artery Bypass (OPCAB)

  • Beating Heart Surgery

  • Coronary Artery Bypass Graft (CABG)

  • Coronary Artery Bypass Surgery

  • Coronary Bypass Surgery

 

 FREQUENTLY ASKED QUESTIONS

 

  • How many bypass surgeries can a person go for?

Depending on number of arteries blocked and size of the vessel up to 6 bypasses surgery can be performed.


 

  • What is beating heart surgery?

The type of heart surgery that is performed while the heart is still beating i.e. without the use of heart-lung machine.


 

  • Where does the graft from coronary artery bypass surgery come from?

The graft used in coronary artery bypass surgery comes from chest, arm and legs.


 

  • Are there any blood transfusion involved in bypass surgery?

Generally blood transfusion is required in bypass surgery.


 

REFERENCES
 

     

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