Heart Bypass Surgery (CABG) Information

Heart Bypass Surgery – Should I have Bypass Surgery?

Heart bypass surgery is a procedure for improving the flow of blood to the heart when you experience coronary artery disease. In this procedure, a surgeon extracts a blood vessel from another portion of your body to bypass a blocked artery.

Most people experience the benefits of this surgery for 10 years or more. Following proper medication and healthy lifestyle choices can prevent blockage of your arteries again.

Understanding Bypass Surgery

A heart bypass is a critical surgery carried out to restore the proper flow of blood to the heart when there are blockages in the coronary arteries or if the heart is narrowed due to coronary artery disease (CAD).

Blockages in the coronary arteries reduce the oxygen supply to the heart, which can lead to shortness of breath, pain in the chest and even heart attacks. Doctors usually recommend this major procedure when medications, lifestyle changes, and other less invasive treatments fail to alleviate the problem successfully.

Why it is Done?

Heart bypass surgery is done to bring back the blood flow around a blocked heart artery. The surgery may be done as an emergency treatment for a heart attack, if other immediate treatments aren't working.

Your healthcare professional might advise coronary bypass surgery in case you are experiencing:

• A blockage in the left main heart artery. This artery sends a lot of blood to the heart muscle.
• Severe narrowing of the main heart artery
• Extreme chest pain due to narrowing of several heart arteries.
• More than one diseased heart artery and your lower left heart chamber doesn't work well
• A blocked heart artery can't be intervene with coronary angioplasty.
• An angioplasty with or without a stent that hasn't worked. For an instance, an artery narrowed again after stenting.

Types and Procedure of Heart Bypass Surgery

The choice of technique for heart bypass surgery or coronary artery bypass grafting (CABG) depends on the patient's condition, the number of blocked arteries, and overall health. Let us look into the different types and their procedure:

1. Traditional On-Pump CABG

This is a common and traditional method that involves the surgeon making a large incision in the chest to reach the heart. They temporarily stop heart activity and use a heart-lung machine to pump oxygen-rich blood. Then, they graft a healthy blood vessel—usually from the chest (internal mammary artery) or leg (saphenous vein) to bypass a blocked artery and restore proper blood flow to the heart muscle.

2. Off-pump CABG (Beating Heart Surgery)

Unlike the traditional method, the doctors do not use a heart-lung machine for this technique. Surgeons use specialised equipment to stabilise the area being operated on while the heart continues to beat during the procedure. This approach may reduce complications like stroke and is suitable for certain patients.

3. Minimally Invasive Direct Coronary Artery Bypass (MIDCAB)

MIDCAB involves small incisions between the ribs, avoiding the need to open the chest fully. Surgeons use specialised instruments, sometimes with robotic assistance, to perform the bypass. This method typically results in less pain, shorter hospital stays, and quicker recovery.

4. Hybrid Coronary Revascularisation

This type of bypass surgery combines surgical and interventional techniques in order to address multiple blockages. Doctors carry out a minimally invasive bypass on one artery.

commonly the left anterior descending artery. The other blockages are treated with stents via catheterisation. It is suitable for patients with specific patterns of coronary artery disease.

Main Reasons for Heart Bypass Surgery

Doctors suggest a heart bypass surgery to treat symptoms of coronary artery disease. This disease takes place when a waxy substance, commonly known as plaque, starts building up inside the arteries in your heart and restricts the flow of oxygen-rich blood to the heart.

Doctors conduct a heart bypass surgery usually when:

• You experience chest pain, which your doctor assumes to happen because of blockage and lack of blood supply to your heart.
• Presence of a blockage in your left main coronary artery, which supplies blood to your left ventricle
• Disfunctioning of the left ventricle (the chamber that pumps most of your heart's blood)
• Presence of new blockages

Is Coronary Artery Bypass Surgery a Serious Surgery?

Surgery to bypass an artery or vein is a serious operation because it means incising the chest and working on the heart. Doctors perform this surgery to unblock your heart arteries if having blocked arteries can give you chest pain or a heart attack. They perform the procedure by creating a new path for blood to be sent to the heart by using a healthy blood vessel taken from another part of the body. 

The surgery typically takes several hours and takes place in the hospital, and the patient requires several weeks of recovery. Some risks include infection, bleeding, or stroke, but in general, this is safe under the care of skilled doctors. Proper care after surgery makes many people much better and allows them to live much longer and healthier lives.

Possible Risks or Complications of Bypass Surgery

The exact probability of risk, though, depends on the profile of individual patients, but on average, it is about 1-2%. Some major risks include:

• Heart attack due to blood clotting after surgery or failure
• Irregular heartbeats
• Bleeding pre or post-surgery
• Kidney Problems
• Stroke or infection which can be life-threatening
• Memory loss or trouble thinking clearly, which often is temporary
• Long term requirement for a breathing machine
• Infection can occur at the area of chest wound

The risk of medical complications is higher in case surgery is done as an emergency treatment.

Your particular risk of medical complications after open heart bypass surgery also depends on your health prior to the surgery. Having the below mentioned medical cases increases the risk of complications:

• Diabetes.
• Kidney disease.
• Blocked arteries in the legs.
• Chronic obstructive pulmonary disease (COPD).

Medicines to control bleeding and blood pressure and to prevent infection are typically given before surgery to reduce the risk of complications. In case you are with diabetes, you may get medicine to control blood sugar during surgery.

Heart bypass surgery is an effective treatment that helps to restore the flow of blood into the heart among patients with coronary artery disease. This surgery helps relieve chest pain, improves how the heart works, and lowers the risk of a heart attack.

All things considered, the benefits of bypass heart surgery outweigh the possible risks for most patients.

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