Heart Bypass surgery




Definition:
A heart bypass surgery is a procedure where a new route is created for blood and oxygen to reach the heart muscles which are deprived of it due to blockages in the existing blood vessels supplying the same.
Alternate names:

  • v Off-pump coronary artery bypass
  • v OPCAB
  • v Beating heart surgery
  • v Bypass surgery - heart
  • v CABG
  • v Coronary artery bypass graft
  • v Coronary artery bypass surgery
  • v Coronary bypass surgery

When is the surgery required:
 Any patient who has been diagnosed with a triple vessel coronary artery disease is required to undergo a bypass surgery.

A triple vessel surgery is diagnosed in case a patient has symptoms like chest pain ,heaviness, breathlessness, at times associated with perspiration, back pain which may radiate to the jaw etc and undergoes an angiography.

Preparations:

1)    Before the surgery

Once the patient has been diagnosed with a triple vessel disease and has been advised to undergo a bypass surgery he has to plan accordingly.

For a bypass surgery a stay in the hospital of approximately 10 days is expected with a recovery time of a month after the surgery to get back to the normal routine.

The patient is generally put on blood thinners after being diagnosed with a triple vessel disease. So before the surgery the patient is expected to stop blood thinners 5 days prior.

The patient plans with his surgeon or assistant doctors to surgeons and comes for pre-operative investigations.
These are important as the surgery would not be carried out unless the patient is found to be fit to undergo surgery.
This is important to avoid complications during surgery and to ensure a smooth recovery.
With any deviation in the parameters the patient is treated for the same before being taken for the surgery.

The pre-operative investigations include the following:
·        Blood tests: includes CBC, Serological tests, blood grouping, blood sugars,
·        Urine tests: creatinine, electrolytes
·        Chest x-ray
·        Ultra sonography
·        Carotid and radial Doppler studies
·        2D Echo
·        CT angiography of the internal mammary arteries
·        Sputum and nasal swabs to check for any active infections in the body
·        Lung function tests


On the day of surgery:

The patient is kept nil by mouth from one night prior to surgery
He  is given tranquilizers for his anxiety on the day of the surgery before being rolled to the OT
He is then rolled in the operation theatre (OT) as per the schedule of the surgery.
Inside the OT he is first attended by an anaesthetist who would prepare the patient.
Firstly electrodes are connected on his back for ECG monitoring
A few IV lines are inserted through which drugs, blood and anaesthetic agents would be injected during the course of the surgery.
A stomach tube is inserted to drain the contents of the stomach so under anaesthesia it doesn’t enter the windpipe.
A catheter is inserted into the urinary bladder to monitor the urine output and collect urine in a hygienic manner.
Once under anaesthesia the surgeon would begin the surgery.
A cut is mid in the midline and the breast bone( sternum) is separated to reach the heart to prepare for the heart surgery.
Under the sternum are the internal mammary arteries that supply the chest wall. As per the plan of conduits to be used the right , left or at times both the internal mammary arteries are harvested from the chest wall by the surgeon.
In the meanwhile another team of surgeons would also harvest conduits from the leg or the hand as per the requirement.
Once all the conduits are ready then begins the grafting process.
After the grafting, begins the resuturing of the sternum to close the chest in layers back to normal.
There are tubes inserted into the chest to drain the fluids and blood that get collected in the chest cavity after the surgery.

After the surgery:

After the surgery the patient is shifted with all the lines as inserted into the ICU where he stays for 3-4 days depending upon his clinical condition.

The ICU stay is highly crucial stage of recovery. Here the patient begins from regaining consciousness and getting oriented. Eventually all the tubes are removed one after the other depending on the monitoring results.
Patient is started on very little fluid followed by sips of water to semi solid to solid diet gradually.
Physiotherapy is given to help recovery of the body.

Once the patient is stable enough to be shifted out of the ICU he is then shifted to the wards where he may stay for 5-7 days depending upon his speed of recovery.
Patient is mobilized and proper nursing is done so he can be back to his basic routine after being discharged from the hospital.

After being discharged the patient has to follow a rigorous regimen of proper diet and timely medicines as advised by the treating doctors. This will help for a speedy recovery and will help maintain the good result.

Timely checks and routine follow ups should be done regularly.

Prognosis:
With timely follow ups, regular intake of medicines and a healthy diet regimen with regular exercise the outlook of the surgery is very good.
Treatment for heart attack
 http://www.asianheartinstitute.org/
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Milan Tomic

Hi. I’m Designer of Blog Magic. I’m CEO/Founder of ThemeXpose. I’m Creative Art Director, Web Designer, UI/UX Designer, Interaction Designer, Industrial Designer, Web Developer, Business Enthusiast, StartUp Enthusiast, Speaker, Writer and Photographer. Inspired to make things looks better.

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