Cardiac Bypass Surgery: Procedure, pre, and post-operative care

Like any other part of the body heart also requires a steady supply of oxygen and nutrients rich blood. The artery that supplies oxygen and nutrients rich blood to the heart is known as a coronary artery. Sometimes there is clogging in the coronary artery due to plaque. Over time the plague deposit can narrow the blood vessels so much that the normal blood flow is restricted. In some cases, the coronary arteries become so narrow that the heart muscles itself are in danger. In such a case, Cardiac Bypass Surgery is performed.

When is cardiac bypass surgery required?

Cardiac bypass surgery is indicated if there is a blockage in the coronary artery. It is up to the doctors to decide whether to opt for cardiac bypass surgery or not. The doctor usually looks for the following symptoms to go forward with coronary bypass surgery:

• Pain in chest
• More than one block in coronary artery
• If there is a blockage in the left main coronary artery
• If there has been a medical history or angioplasty or stent implant but still restenosis or narrowing of the arteries is found.
• In cases of emergency like heart attack and the patient is not responding to any other treatment.

Procedure for bypass surgery:

This surgery lasts usually between 3-6 hours and is performed under the effect of anesthesia. The patient is connected to the ventilator which helps them to breathe during and after the surgery.

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Types of coronary bypass surgery

• The patient is also attached to a heart-lung machine to provide oxygenated blood to the body when the heart is temporarily stopped to perform surgery on it. This type of bypass surgery is known as on-pump coronary bypass surgery.

After exposing the heart and stopping it from functioning the surgeon takes a healthy blood vessel from interiors of the heart or sometimes from the lower extremities and attaches it at the upper and lower end of the clogged blood vessels to redirect blood flow.

• Off-pump or beating heart surgery: In this type, the operation is conducted without stopping the heart hence known as beating heart surgery.
• Minimal invasive surgery: In this type of surgery a small invasion is made and the surgery is done with the help of robotics and video imaging.

Preoperative care:

Medicines should be taken as advised by the doctor prior to the surgery. It usually takes 4-6 weeks to recover after the surgery.

Postoperative care:

After the surgery, the patient is moved to the Cardiac care unit and is kept there for 1-2 days. Later the patient is shifted to the other ward of the hospital. Still, the patient has to stay between 5-7 days in the hospital after surgery.

Patients are advised not to indulge much in any physical activity up till 12 weeks after surgery. Once recovered the patient is advised few lifestyle changes which include:

• Stop smoking
• Reduce alcohol consumption
• Reduce stress
• Control blood pressure
• Keep a check on blood cholesterol levels
• Eat healthy food
• Exercise regularly
• Manage a healthy weight

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Is the surgery safe?

Coronary bypass surgery is very safe and has good results. Except people who suffer from medical conditions like emphysema, diabetes, kidney disease, or peripheral artery disease are more prone to develop complications during and after surgery.

When to see a doctor post-operation?

Patients should immediately see a doctor if they experience the following symptoms:

• If the patient complains of chest pain
• High fever
• Pus or redness at the site of incision
• Rapid heart rate.

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