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Heart Surgery

This surgery is done to by-pass clogged arteries supplying the heart.

Coronary artery bypass surgery is a treatment option for ishcemic heart disease (too little blood reaching the heart muscle).

Coronary surgery is indicted when there is disease of the left main coronary artery, there is disease of three or more vessels (triple vessel disease), or there was failure of nonsurgical management.

Non surgical management includes medication and/or angioplasty.

Symptoms

The early signs of ischemic heart disease are normally angina (chest pain) and shortness of breath.

A person may have no symptoms; have mild, intermittent chest pain; or have a stronger and steadier more frequent pain; others have CAD that is severe enough to make normal everyday activities difficult.

Symptoms that usually bring a person to a doctor are a feeling of heaviness, tightness, pain, burning, pressure, or squeezing.

This is usually behind the breastbone, but sometimes it is also in the arms, neck, or jaw

Many people simply have heart attacks without ever having any of these symptoms first.

In cases where there are no symptoms, a doctor may suspect CAD and perform a stress test to determine if it is present.
CAD is common if there is a family history of heart disease and a combination of other factors, including high blood cholesterol, diabetes mellitus, high blood pressure, cigarette smoking. Men are also normally more at risk than women

In the majority of people who have the surgery, the grafts remain open and functioning for up to 15 years.

CABG will improve blood flow to the heart but will not prevent the eventual recurrence of coronary blockage and a patient must make a lifestyle choice to avoid future complications. Lifestyle changes such as not smoking, improved diet, regular exercise, and treating high blood pressure and high cholesterol are normally the most common that are needed.

The operation

Heart bypass surgery is just one treatment for heart related problems.

After the operation, the patient will spend about days in the hospital, with the first 2 hours in an intensive-care unit (ICU). In the ICU, heart function is monitored continuously.

Patients may require the temporary assistance of a breathing tube for a few hours after surgery.

Tubes drain fluid from around the heart and are usually removed one to three days after the surgery is completed.

A urinary catheter in the bladder drains urine until the patient is able to void on his own.

Intravenous lines (IV) provide fluids and medications. The patient is under surveillance and doctors and nurses watch and check vital signs (pulse, temperature, and breathing).

When constant monitoring is no longer needed, usually within 12-24 hours, the patient is moved to a regular hospital bed.
Activity is gradually resumed and the patient may begin a cardiac rehabilitation program within a few days. The incision in the chest does not bother most people after the first few days.

After surgery, it takes 4-6 weeks to start feeling better. During recovery it is normal to:

Have a poor appetite -- it will take several weeks for it to return.

Have swelling in the leg if the graft was taken from the leg. Elevating the leg and wearing elastic TED hose for several weeks helps reduce swelling.

Have difficulty sleeping at night, this will improve in time.

Have constipation.

Have mood swings and feelings of depression, this will again improve with time.

Have difficulty with memory or feel confused, again this gets better in time.

The success of surgery

The full benefits from the operation may not be determined until up to 6 months after surgery.

Sexual activities may be resumed 4 weeks after surgery.

All activities that do not cause fatigue are permitted, and the schedule for resuming normal activities is determined with the help of the medical staff.

Today, success rates for heart bypass surgery are excellent and success rates are improving all the time and the vast majority of cases patients make a full recovery