Coronary artery bypass grafting – Coronary artery bypass grafting

Description coronary artery bypass grafting

Coronary artery bypass grafting (AKS) It is an operation to restore blood flow to the heart muscle. The procedure is performed using the blood vessel, taken from other body parts, which direct blood to bypass the blocked coronary (heart) arteries.

In some cases, coronary artery bypass grafting is done?

Atherosclerosis It is a disease of the arteries, in which cholesterol and fatty deposits build up on artery walls. This restricts blood flow. When this occurs in the heart, that can lead to pain in the chest, called stenokardiey, or serdečnomu approach. For the treatment of atherosclerosis can be used lifestyle modification and medications. When the blockage is too heavy, CABG is done to restore the blood supply to the heart muscle. Very often it is recommended if you have coronary bypass surgery:

• Severe blockage in the main artery or a few blood vessels, that supply blood to the heart muscle;
• Lingering pain in the chest (angina), not passing with medical treatment or the use of other procedures.

Possible complications after coronary artery bypass grafting

If you plan to perform coronary artery bypass grafting, then you need to know about possible complications, which may include:

• Infection;
• Blood clots;
• High or low blood pressure;
• Bleeding;
• Stroke;
• Damage to other organs, such as kidney;
• Irregular heart rhythm;
• Death.

Some factors, that may increase the risk of complications include:

• Lung disease, particularly chronic obstructive pulmonary disease (эmfizema);
• The presence in the past heart attacks or bypass surgery;
• Advanced age;
• The need for emergency surgery;
• Obesity;
• Diabetes;
• Smoking;
• High blood pressure;
• Thyroid disease;
• Depression.

How to conduct coronary artery bypass grafting?

Preparing for Surgery

They can be assigned to the following tests:

• Physical examination;
• Chest X-ray;
• Electrocardiogram (ECG) - Analysis, which records the activity of the heart, measuring the electrical current through the heart muscle;
• Coronary angiogram - Analysis, to determine the extent and location of blockages in the blood vessels in the heart.

Maybe, you need to stop taking aspirin or other anti-inflammatory drugs for a week before surgery. Maybe, also need to stop receiving blood-thinning drugs, Taki how clopidogrel or warfarin.

• In the evening before surgery you can eat a light meal. You can not eat or drink anything after midnight on the day of the procedure;
• We need to organize a trip to the hospital and back after surgery;
• Need to arrange assistance at home after the procedure.

Anesthesia

During the operation applies general anesthesia. The patient is in a state of sleep.

Describes how coronary bypass surgery

Once the patient is asleep and feels no pain, throat breathing tube will be placed.

On the skin of the chest incision. The belly is cut, to open the chest. To the heart of the cardiopulmonary bypass is connected. Because the heart must be stopped for the duration of the operation, He will perform the functions of the heart and lungs.

As bypass vessels used an artery from the chest, or part of the legs. When the heart stopped, the new vessels will be sewn to the blocked arteries. One end of the vessel will be sewn just above the blockage. The other end of the, respectively, be attached slightly below the blockage. When grafts are in place, heart will “running” Once again. In some cases, to restore heart rhythm may be necessary to use electrical current. Cardiopulmonary bypass is disabled. Temporary drains may be placed in the chest, to help in the removal of fluid accumulating. Cut parts of the sternum will be joined together again. Leather is stitched on the chest.

There is a less invasive approach, called minimally invasive surgery for coronary artery disease (minimally invasive cardiac surgery). The aim of this operation is the same, but another technique. Patients, which have only one or two blockage in arteries may be candidates for this type of operation. In this processing technique, a small incision is made in the chest. To bypass the damaged vessel doctor typically uses arteries from the inside of the breast. The main feature of this technique is that the, that the heart does not stop during the operation, and cardiopulmonary bypass is not used. This type of surgery is quite promising. Before you perform the minimally invasive surgery on a coronary artery will need to weigh the benefits and risks for the individual patient.

Immediately after the procedure of coronary bypass surgery

The patient sent to NICU. Connect various devices, to monitor and manage vital indicators:

• Heart Monitor;
• Conductor, stimulating cardiac muscle pulsed current, to control heart rhythm;
• Drains are connected to the device, that suck the excess blood and air from the wound;
• While the patient is unable to breathe on their own, He has a respiratory tube or oxygen mask;
• The bladder catheter is inserted.

How long is coronary artery bypass surgery?

Duration of operation 4-5 hours.

Coronary artery bypass grafting – Will it hurt?

Anesthesia prevents pain during surgery. During the recovery the patient are given pain medicine.

The average time of stay in the hospital after coronary bypass surgery

Duration of stay in hospital 5-7 days.

Patient care after surgery, coronary bypass surgery

Care in a hospital

• To reduce the risk of fluid in the lungs, need to breathe deeply and cough 10-20 times each hour;
• If you removed the legs of Vienna, We recommend that you raise your legs above your heart level, Do not put when sitting legs;
• Measures will be taken, that the patient was able to safely and as soon as possible to get up out of bed and started walking;
• Dressings will be removed a day or two. Stimulating heart of conductors and breathing tubes are removed in a few days.

Home Care

Upon returning home, we recommend you do the following:, to ensure the normal recovery:

• Take medication prescribed by a doctor. List of medications may include:
  • Drugs to lower cholesterol;
  • Painkillers;
  • Medications to control blood pressure (eg, beta-blockers, ACE inhibitors);
  • Antiarrhythmic medications to stabilize heart rhythm;
  • Blood-thinning drugs, to prevent blood clots;
• Internal stitches dissolve on their own after some time. The outer seams or staples will be removed through 5-7 days after surgery;
• We need to take medication, approved by physician;
• Need to be weighed every morning;
• In accordance with the recommendations of the doctor will be assigned to a program of cardiac rehabilitation, to speed recovery and reduce the risk of cardiovascular disease;
• We need to ask your doctor about, when it is safe to shower, bathe, or to expose the surgical site to water;
• Be sure to follow your doctor's instructions.

Bypass surgery does not cure heart disease. Sewed blood vessels can foul. We recommend that you change your lifestyle to reduce the risk of cardiovascular disease:

• Physical exercise;
• No smoking;
• Eat food, which contains low amounts of saturated fat, sugars and salt. It is important to eat food, that high-fiber foods. This can provide fruit and vegetables.

Most patients can return to work through the Office type 4-6 weeks.

Communication with a physician after carrying out coronary bypass surgery

After discharge from the hospital need to see a doctor, If the following symptoms:

• Pain, which does not pass after taking pain medication appointed;
• Signs of infection, including fever and chills;
• Redness, edema, increased pain, bleeding, or discharge from the incision;
• Nausea and / or vomiting, which do not disappear after taking the prescribed medicines, and persist for more than two days after discharge from the hospital;
• Cough, shortness of breath or chest pain;
• Pain, burning, frequent urination or persistent blood in the urine;
• Increase the weight of more than two kilograms for one or two days;
• Pain and / or swelling of the legs, caviar, Foot;
• Sudden shortness of breath or chest pain.

In the case of a serious and rapidly deteriorating health should immediately call an ambulance.