Bypass Heart Surgery

Bypass Heart Surgery – To increase blood flow to the heart, bypass heart surgery, or coronary artery bypass graft (CABG) surgery, is performed. Blood vessels taken from another part of the body are used by a surgeon to bypass the blocked arteries.

Per year, doctors perform about 60,000 such surgeries in India.

When coronary arteries become blocked or damaged, this operation is recommended. Oxygenated blood supplies the heart with these vessels. The heart doesn’t function properly if these arteries are blocked or blood flow is limited. This can lead to heart failure.

Also See: Bypass Heart Surgeon in Chandigarh

What are the different types of bypass surgeries?

Depending upon what grafts are used to bypass the blocked arteries of heart, bypass heart operation can be of different types :-

  1. Total arterial bypass:- Arterial grafts like internal mammary artery (IMA) and Radial artery (RA) are commonly used in this technique. Arterial grafts have been proven to last longer than vein grafts.
  2. Single arterial bypass:- Only one arterial graft is used and other heart vessels are bypassed with veins taken from the leg of the patient. This technique is most commonly used all over the world.
  3. All venous grafts, no arterial grafts:- This technique is least preferred as it is recommended to put at least one arterial graft to LAD (Left Anterior Descending) artery.

Depending upon technique also bypass surgery can be of three types :- 

  1. Minimal Invasive Cardiac Surgery (MICS):- In this technique, no bone is cut but only a small 2-3 inch incision is taken on the side of the chest. Patients have better recovery and less restrictions after surgery with MICS technique. It is technically challenging and not all patients are suitable for this technique.
  2. Open Heart technique:- This is the most commonly used technique worldwide. Here 6-7 inch cut is made on the front of the chest, Sternal bone is cut to access the heart. For poor heart function, recent heart attack and poor target vessels, this technique is preferred.
  3. Hybrid technique:- MICS arterial graft is placed on LAD (most important artery of heart) and rest arteries are stented. This is a newer concept and gaining popularity.

Why does a person need bypass surgery?

  • Due to age and cardiac risk factors, Cheesy material (plaque) builds up on arterial walls. This build up of plaque blocking heart muscle blood flow is called Coronary Artery Disease (CAD).
  • The heart, if it does not receive enough oxygen, is more likely to become tired and fail. Any arteries in the body can be damaged by this process of atherosclerosis.
  • If your coronary arteries are so narrowed or blocked that you run a high risk of a heart attack, your doctor can suggest bypass heart surgery.
  • Bypass surgery is also advised by the doctor if the blockage is too extreme to be treated with medicine or other therapies like stenting.

How can we help you determine the need of bypass surgery?

  • Any blockage in the heart on angiography that is more than 70% and causing chest pain, breathlessness or decrease of heart function; will require either stenting or bypass heart surgery. 
  • When blockage is short, non calcified, away from origin or bifurcation of heart arteries then stenting is suitable. If blockages are multiple requiring many stents then bypass heart surgery is suitable. 
  • Stent life is short especially in the presence of diabetes and calcification of heart arteries. Bypass heart surgery becomes more difficult after multiple long stents are placed. 

What medications are given after bypass surgery?

  • In general medications requirements are less after bypass surgery
  • For one week there are few antibiotics and painkillers, along with small doses of blood thinning medications.
  • Disease risk modifying agents like beta blockers, ace inhibitors and Aldactone are also used depending upon renal functions and blood pressure of the patient.

Also See: Pediatric Heart Surgeon in Chandigarh