Heart bypass surgery, also called coronary bypass surgery, is needed when an artery becomes so clogged that a new blood supply delivery route must be created in order to keep the heart fully supplied with oxygen-rich blood. According to the American Heart Association, 448,000 heart bypass surgeries were performed in the United States in 2006.
Reasons for Surgery
Coronary bypass surgery is generally only performed when other methods, such as medication and lifestyle changes, haven't relieved symptoms or if blockages become life-threatening. Blockages occur when plaque, a fatty substance often caused by high cholesterol levels, clings to the sides of the arteries, causing them to narrow. Surgery may be considered if the left main coronary artery is blocked or extremely narrow. Most of the blood that reaches the left ventricle is supplied by the left main coronary artery, making it crucial that this artery remain clear. If the left ventricle is not functioning properly and there is more than one diseased artery, surgery may also be recommended. Surgery may be needed if you have severe chest pain accompanied by significant narrowing of the arteries that can't be relieved by placing a stent in your artery to keep it open. A stent is a mesh tube inserted into an artery to prop it open.
Bypass Surgery
Before surgery, a healthy blood vessel will be removed from another part of your body to be used as a graft. The graft will be attached to your heart and used to bypass the diseased artery. In some cases, an artery may be used from the chest wall, and in others, a long vein in the leg will be used. In either case, one end of the new blood vessel is attached above the disease area, while the other end is attached below the diseased area, allowing blood to once again flow freely into the heart. During surgery, a large incision is made in the chest, exposing the heart. Depending on the number of arteries that will be bypassed, surgery may take between 3 to 6 hours.
Types of Bypass Surgery
On-pump coronary artery bypass surgery is the most common type of the procedure. During this procedure, your heart will be temporarily stopped and you will be placed on a heart-lung machine that will circulate blood through your body. This method allows your surgeon to operate on your heart while it is still. You will also be placed on a ventilator, a machine that breathes for you by distributing oxygen throughout your body. After the bypass has been completed, the heart is restarted. Off-pump coronary artery bypass surgery is performed while your heart is still beating, although special equipment is used to stabilize the area of the heart that needs the bypass. This type of surgery is more complex because the heart is still beating and it may not be a realistic option for everyone.
Recovery
After the surgery, you will probably spend 1 or 2 days in the intensive care unit of the hospital, where your vital signs will be monitored. At some point during the first day, you may be removed from the ventilator and will begin breathing on your own. Hospital stays following a heart bypass surgery typically last 1 week. When you return home, you may find that it is difficult to perform your usual activities. Even walking may be challenging at first. You will gradually become stronger, and in most cases, will be able to resume working in about 6 weeks.
Prevention/Solution
Clogged arteries can tend to recur, particularly if you don't make any changes in your lifestyle after surgery. You can reduce your risk by modifying your diet, monitoring your blood cholesterol levels, controlling high blood pressure and diabetes, stopping smoking, maintaining an appropriate weight for your height and exercising regularly.
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