Your doctor may do blood tests before the procedure to find out how long it takes your blood to clot. If you smoke, quit smoking as soon as possible. This will improve your chances for a successful recovery from surgery and benefit your overall health. Coronary artery bypass graft surgery CABG requires a stay in a hospital. Procedure may vary depending on your condition and your doctor's practices.
The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery. Once you are sedated put into a deep sleep , a breathing tube will be put into your throat and you will be connected to a ventilator, which will breathe for you during the surgery.
A healthcare professional will insert an intravenous IV line in your arm or hand. Other catheters will be put in your neck and wrist to monitor your heart and blood pressure, as well as to take blood samples. Once all the tubes and monitors are in place, your doctor will make incisions cuts in one or both of your legs or one of your wrists to access the blood vessel s to be used for the grafts.
He or she will remove the vessel s and close those incision s. The doctor will cut the sternum breastbone in half lengthwise. He or she will separate the halves of the breastbone and spread them apart to expose your heart. To sew the grafts onto the very small coronary arteries, your doctor will need to stop your heart temporarily. Tubes will be put into the heart so that your blood can be pumped through your body by a heart-lung bypass machine. Once the blood has been diverted into the bypass machine for pumping, your doctor will stop the heart by injecting it with a cold solution.
When the heart has been stopped, the doctor will do the bypass graft procedure by sewing one end of a section of vein over a tiny opening made in the aorta, and the other end over a tiny opening made in the coronary artery just below the blockage.
If your doctor uses the internal mammary artery inside your chest as a bypass graft, the lower end of the artery will be cut from inside the chest and sewn over an opening made in the coronary artery below the blockage. You may need more than one bypass graft done, depending on how many blockages you have and where they are located. After all the grafts have been completed, the doctor will closely check them as blood runs through them to make sure they are working.
Once the bypass grafts have been checked, the doctor will let the blood circulating through the bypass machine back into your heart and he or she will remove the tubes to the machine. Your heart may restart on its own, or a mild electric shock may be used to restart it. Your doctor may put temporary wires for pacing into your heart. These wires can be attached to a pacemaker and your heart can be paced, if needed, during the initial recovery period.
Once your doctor has opened the chest, he or she will stabilize the area around the artery to be bypassed with a special instrument. The heart-lung bypass machine and the person who runs it may be kept on stand-by just in case the procedure need to be completed on bypass. The doctor will do the bypass graft procedure by sewing one end of a section of vein over a tiny opening made in the aorta, and the other end over a tiny opening made in the coronary artery just below the blockage.
You may have more than one bypass graft done, depending on how many blockages you have and where they are located. Before the chest is closed, the doctor will closely examine the grafts to make sure they are working. Your doctor will sew the sternum together with small wires like those sometimes used to repair a broken bone.
He or she will insert tubes into your chest to drain blood and other fluids from around the heart. Generally, you should be able to sit in a chair after 1 day, walk after 3 days, and walk up and down stairs after 5 or 6 days. You should be able to return to most of your normal activities after about 6 weeks, including working, driving and having sex.
These are usually relatively minor and treatable, such as an irregular heartbeat or a wound infection, but there's also a risk of serious complications, such as a stroke or heart attack. After having a coronary artery bypass graft, most people will experience a significant improvement in symptoms such as breathlessness and chest pain , and their heart attack risk will be lowered. If you don't make lifestyle changes, such as eating a healthy diet and exercising regularly , your grafted arteries will also eventually become hardened and narrowed.
In some cases, a coronary artery bypass graft may need to be repeated or you may need a procedure to widen your arteries using a small balloon and a tube called a stent coronary angioplasty. It's a less invasive operation where a long, flexible, hollow plastic tube called a catheter is inserted into a blood vessel in your arm or groin.
The tip of the catheter is guided under X-ray to the arteries that supply your heart, to the point where the narrowing of the artery has occurred. A balloon attached to the catheter is then inflated to widen the artery and a small metal tube called a stent is often used to help keep the artery open. It usually takes less time to recover from a coronary angioplasty than from a coronary artery bypass graft, but there's a higher chance that the procedure will need to be repeated.
Doctors recommend heart bypass surgery when one or more of the blood vessels that transport blood to the heart muscles become partially blocked. Heart bypass surgery is a complicated procedure that involves a significant amount of preparation and recovery time.
Occasionally, someone must undergo emergency heart bypass surgery, but most of the time the operation is planned. Heart bypass surgery is a relatively safe and effective procedure that reduces the risk of heart attack and death. The procedure might also ease symptoms of coronary artery disease , such as chest pain.
Doctors typically have a range of options at their disposal to fix the blockage. If left untreated, coronary artery disease can lead to heart attack and even death.
When possible, doctors may try to resolve the issue of blocked arteries with medication and less-invasive procedures, such as a stent. If these options do not work or are not suitable for an individual, surgeons might decide to perform heart bypass surgery. Heart bypass surgery is one of the most effective weapons against blocked arteries and the problems they cause.
According to the American Heart Association , CABG involves removing a blood vessel from the chest, arms, or legs and using it to create a detour or bypass around the blockage. This allows blood to reach the heart again. Surgeons can address more than one artery in a single operation.
A double bypass involves two repairs, a triple bypass involves three, and a quadruple bypass involves four. The quintuple bypass is the most intricate heart bypass surgery and includes all five of the major arteries feeding the heart. Removing a blood vessel from another part of the body will not substantially affect blood flow in the area the vessel came from.
Heart bypass surgery is typically an open-heart surgery , which means that the surgeon cuts the chest open to reach the heart.
On-pump surgery involves using a heart-lung machine that circulates blood and breathes for the body. The machine allows doctors to stop the heart, which makes the operation easier. Risks and potential complications vary for each person. Commonly, between two and four coronary arteries are grafted, depending on the location and severity of the blockages. The surgeon accesses your heart using one of two possible incisions: either cutting down the length of your breastbone median sternotomy or cutting beneath the left nipple thoracotomy.
A heart-lung machine maintains your blood circulation while your heart is deliberately stopped. The vein or artery is then grafted onto the narrowed segment of coronary artery, which allows the blood flow to bypass the blockage.
Sometimes, the operation is performed while the heart is still beating this is called 'beating heart' or 'off-pump' surgery. You should talk to the medical staff if you have any fears or anxieties over the few days immediately after the operation, as emotional stress can make demands on your heart.
Following the operation:. Your wellbeing in the long term depends on your commitment to healthier lifestyle changes. For example, if you continue to smoke and eat a high-fat diet, your bypass graft may eventually become clogged with fatty plaques.
You will need to regularly consult with your health professionals including your doctor and surgeon to ensure proper cardiac rehabilitation. Some common experiences for patients in the weeks and months following heart surgery include:.
Most patients will be free of angina after surgery and will have a lower risk of heart attack, and they will usually be able to lead a more active lifestyle.
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