What is Heart bypass surgery?
Heart bypass surgery, also called Coronary artery bypass grafting surgery (CABG) is the commonest heart operation done these days. It is done for patients who have blocks in the coronary arteries-blood vessels that supply blood to the heart. These blocks develop due to the deposition of fats in the walls of blood vessels. People with some risk factors like diabetes, hypertension, high cholesterol, obesity, family history, and smoking are more prone to develop these blocks.
Due to the blocks, patients can develop chest pain (angina), heart attacks or sometimes may die suddenly. Sometimes, these are detected during routine health checkups. Once the blocks are suspected, coronary angiogram test is done. It will show the location of blocks, number of blocks, and severity of blocks. If there are multiple blocks, especially in diabetic patients, bypass surgery is offered.
Heart Bypass Surgery Procedure:
Normally heart bypass surgery is done from the front of the chest through breast bone (median sternotomy). About 20-25cm cut is given on the breast bone and then breast bone is cut to expose the heart.
Often heart is stopped during surgery with the help of artificial heart lung machine.
These days most of the bypass surgeries are done on a beating heart with the help of special equipment. Even though millions of patients have undergone surgery through median sternotomy, there are some problems with it.
Median Sternotomy
A large scar on the front of the chest makes some people refuse this life saving surgery. Bleeding is more and often require more blood transfusions. Infections (mediastinitis) can be disastrous. It takes 3 months for the bone to heal and pain to reduce. Some patients come back for second operations on heart letter. Then it becomes difficult. Nowadays some of these patients can be offered minimal access bypass surgery, also called key hole bypass surgery. Instead of the long bone cutting incision on the front of the chest, the same surgery is done through a small incision on the left side of the chest. As many as 3-4 bypasses can be done through this approach. Often this is done on a beating heart without the use of heart lung machine. Patient recovery is faster and can go back to work in 3-4 weeks. Bleeding and infections are less. Scar is small and cosmetic.
Dr. A.G.K.Gokhale, India has one of the largest experiences in minimal access bypass surgery and in minimal access valve surgery. He has been conducting live workshops regularly helping more heart surgeons perform these procedures so that patients get benefited.
All the patients who undergo bypass surgery have to take regular medicines prescribed and follow certain life style modifications – like doing exercises as advised by their doctor, dietary precautions, control of diabetes, high blood pressure, cholesterol levels, stress controlling techniques etc. They have to go for regular checkups as they can develop further blocks in coronary arteries.
