CORONARY ARTERY BYPASS SURGERY

GIVE YOUR HEART ANOTHER CHANCE

The main reason underlying “Coronary heart disease” is insufficient blood flow to the heart muscle. Coronary artery disease may manifest itself as pain, pressure or numbness in the chest, arms, lower jaw, throat or back. These symptoms maybe attributed to indigestion. Coronary artery disease may also present as shortness of breath or easy tiring. The first presentation of coronary artery disease may also be a heart attack without any preceding warning signs. If you have any of the complaints listed above, it may be time to evaluate your heart.

Your doctors would run some diagnostic tests to determine the extent of your heart problem. One of these may be a coronary angiography. These tests are done to uncover the severity of the blockages in your heart arteries and your doctors now recommend coronary artery bypass surgery. It will be possible to reestablish blood flow to the heart muscle with this procedure.

Your heart is approximately the size of your fist. However your heart is responsible to pump blood to he whole body. Therefore, the heart muscle needs enough oxygen to be able to perform this heavy duty.

The coronary arteries ensure delivery of uninterrupted oxygenated blood to your heart muscle. There are two main coronary arteries, right and left coronary arteries. Both coronary arteries divide into multiple smaller branches and cover the heart with a network of blood vessels.

Blood flow in a healthy coronary artery is usually uninterrupted and plentiful. This guarantees delivery of nutrients and oxygen to the heart muscle even during exercise with increased demand.

High cholesterol, high blood pressure and tobacco use may damage your arteries and may results in atherosclerosis (hardening of the arteries). Atherosclerosis is due to deposition of calcium and cholesterol and other fats in the blood vessel wall. The result is disturbance of the blood flow in the coronary arteries and is the beginning of coronary artery disease. The further increase in the atherosclerotic thickening will further decrease the blood flow and will lead to the development of the signs and symptoms listed above. If the coronary arteries get completely blocked by the atherosclerotic process, this will result in a myocardial infraction (heart attack) and will lead to irreparable damage in your heart.

Coronary artery bypass surgery will reestablish blood flow to your heart muscle. The surgeons use blood vessels from other parts of the body to make new blood vessels for the heart. Number of bypass grafts will vary depending on the number of blocked arteries and their side branches.

Bypasses are the new blood vessels that are taken from inside the chest wall, your arms or your legs. These are usually “spare” blood vessels and their use as bypass grafts will not have any untoward effects on your body.

A member of the heart surgery team will meet with you and give you and your family detailed information about what to expect before and after surgery. It is normal to a bit nervous before the surgery. The hospital employees will be able to ease your concerns and answer your questions.

Your surgeon will inform you about the risks of this surgery. These are briefly infection, bleeding, stroke, heart attack and death.

PREPARATION FOR SURGERY: 
Some of the medications you maybe taking may increase bleeding during surgery. Therefore it is utmost importance to notify your doctors about the complete list of your medications. You should inform your anesthesiologist about any previous disease history. Do not eat or drink anything after midnight on the day of surgery. Parts of your body will be shaved prior to surgery to prevent wound infection.

Each member of the surgical team has an irreplaceable responsibility during the surgery. Our surgeon will perform the procedure with the help of the assistants and the scrub nurses. Your anesthesiologist will be monitoring you closely during the procedure and ensures a painless operation. The perfusionist will be operating the heart lung machine (the cardiopulmonary bypass pump). Your vital signs will be continuously monitored throughout the procedure.

Your surgeons will access to your heart through the breast bone. This bone will be brought back using stainless steel wires at the end of surgery. Your wounds will heal in approximately 6 weeks.

The surgeons will connect the blood vessels taken from the inside of the chest wall and arms and legs to the blocked arteries on your heart. The surgery will take about 3-4 hours. The patients will be taken to the intensive care unit after the procedure. Your family will be able to visit you in a few hours and will be notified about the patient’s progress continuously. You will stay in the intensive care unit for one or two nights.

It is normal to feel thirsty and cold after the surgery. Your nurses will administer analgesics for pain. You should not be surprised to see various tubes and monitors attached to your body. These will be monitoring your heart rate, blood pressure and oxygenation. The tubes will help to monitor any abnormal bleeding and a catheter will drain your bladder and ensure adequate kidney function. A breathing machine will help you breath until you are fully awake. These tubes and catheters will be removed when they are no longer needed.

You will be taken to the monitored floor after the intensive care unit. Early ambulation after cardiac surgery is required to reestablish muscle strength and regulating the blood pressure. Your nurses and the physical therapist will assist you in sitting up and walking exercises.

Your surgeon will inform you about your discharge medications, diet and physical therapy and cardiac rehabilitation at the time of discharge. Do not hesitate to ask any questions you might have at this time.

The time period required for complete recovery is different for every patient however you will usually be able to gain your preoperative strength in 6-8 weeks after the surgery. It is very important to keep in contact with your doctor and take all your medications as prescribed for an uneventful recovery.

Your doctor visits are an important part of the recovery process. You surgeon might want X-Rays or blood tests during the follow-up visits. EKG might be required to detect the changes in the heart rhythm.

Contact our doctor if you have one of the complaints below:

Gaining too much weight in a short period of time (weigh yourself everyday)
Shivering or profuse sweating or fever (>38 C or 101.4 F)
Shortness of breath while lying down
Swelling, redness, tenderness or drainage from the wound
Unexplained excessive bleeding or bruising
WOUND CARE:
It is normal to have some bruising, itching, numbness or pain around the wound for a few weeks following the surgery. You can shower daily however it is not recommend to swim in a pool. Wash the wound gently with soap or water in the shower. Do not put any creams or ointments since it will increase the chance of a wound infection.