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What is Coronary Artery Bypass Surgery?
Coronary artery bypass surgery is often the best solution for patients suffering from severe coronary artery disease, called atherosclerosis. Atherosclerosis is the result of fatty build-up on the inner walls of the arteries. The fatty build-up can narrow the arteries and restrict the normal flow of oxygen-rich blood, or can actually block the flow of blood altogether. During bypass surgery, surgeons take a blood vessel from another part of the body and construct a detour around the blocked part of the coronary artery. The breastbone is split open to gain access to the heart, but the heart itself is not opened. There are two common procedures for acquiring a vessel for the bypass:
- One end of an artery from the chest wall is detached then reattached to the coronary artery below the blocked area.
- A piece of a long vein in your leg or an artery in your arm is removed and used as the vessel for the bypass. One end of the vessel is attached to the large artery leaving your heart and the other end is attached to the coronary artery beyond the blocked area.
Either way, a new path is created so that blood can flow freely to the heart.
What is Off-Pump Bypass Surgery?
This is a new technique that is used to perform a coronary artery bypass procedure without the use of a heart-lung machine. Benefits of this procedure are reduced blood transfusion and shorter hospitalization. Your doctor will decide which treatment is best for you after reviewing your angiogram.
What to Expect
Prior to your surgery you will have a full medical and cardiac evaluation that usually includes cardiac catheterization (an examination of the coronary arteries) and a coronary angiogram ventriculogram (an x-ray picture of the pumping action of the lower left part of your heart). The bypass surgery procedure is performed under general anesthesia. You will recover in the intensive care unit of the hospital and will be monitored closely for 24 hours in most cases. You will have several tubes to help you breathe, empty your bladder and provide medications. Once your condition is stable and the tubes are removed, you will be moved to a regular hospital room where you will spend 3 - 5 days. You will then receive physical, respiratory and occupational therapy. Bypass surgery is a major surgical procedure, so it is important that you speak with your doctor in advance about possible complications, as it does carry some risks.
After Surgery Care
Your recovery time at home will be approximately one to two months. You will have follow-up visits during that time to monitor your progress and the success of the surgery. Your doctor or cardiologist will place you on a specialized post-operative rehabilitation and prevention program. It is essential that you follow your physician's instructions about reducing your risk of developing further atherosclerosis by stopping smoking (if you smoke), reducing your consumption of high fat and high cholesterol foods, following your doctor's recommended exercise program and learning how to control your blood pressure. Sexual activities may be resumed three to four weeks after surgery. If a blood vessel in your leg or arm was removed for the procedure, you should be somewhat careful in protecting that area since it may take a few months to fully heal.
Most people who have sedentary office jobs can return to work in four to six weeks. Those who have physically demanding jobs will need to wait longer. In some cases, they may need to find other employment with less physical activity.
Hope for the Future
By providing your heart with life-giving oxygen, coronary artery bypass surgery can help ensure a longer, healthier life.
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