Coronary bypass surgery is when the surgeon uses a section of a patient’s vein or artery to bypass a blockage in their heart. The operation is done to treat angina pectoris, to return a blood flow to the heart after the patient’s had a heart attack and to prevent a heart attack if the arteries of the heart are blocked.
The patient undergoes several tests before bypass surgery, including blood work, electrocardiography or ECG, sonograms and cardiac catheterization. They will also have an ECG and angiograms during the surgery. During the operation, the doctor takes a section of the saphenous vein in the lower limb or the mammary artery in the chest. It is set aside while the cardiovascular system is prepared.
The doctor makes an incision through the patient’s breastbone then uses a spreader to expose their heart. The heart is stopped and cooled down. The patient’s circulation and breathing are taken over by a heart-lung machine.
The vein or artery to be used as a bypass is then sutured into place and creates a conduit for blood to flow past the blockage. The heart is then warmed and shocked. This causes it to resume beating. The patient can then be disconnected from the heart-lung machine. The surgeon rejoins the edges of the breastbone with metal sutures and sutures the muscles, tissue and skin above it.
Bypass surgery is performed while the patient is under general anesthesia. When the operation is over, the patient stays in the hospital for about a week. It takes most patients about six weeks to recover, and the outcome is good for most patients. In many patients, their angina pectoris is resolved, and their risk of having a heart attack is reduced.
The patient will be urged to get out of bed as soon after their surgery as practicable to avoid blood clots in their deep veins and to guard against the depression that sometimes afflicts bypass patients. Once home, they should assume their usual activities as soon as the doctor tells them that they can. Patients should ask their doctor about exercise programs and changes to their diet to protect them against any further cardiovascular problems.
The doctor prescribes pain medication for the patient to take in the days after their surgery. Pain meds shouldn’t be taken for more than a week, but the patient should take them whenever necessary. Doctors also prescribe drugs to prevent clots and arrhythmias and to strengthen the patient’s heart muscle.