best cardiac arrest treatment

Bypass Surgery

Navigate your way to a Healthy Heart

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What is a bypass surgery?Imagine traveling by road and getting stuck in a traffic jam. To 'bypass' the jam, you take another route and join the same road back again. That's exactly what takes place in a CABG (Coronary Artery Bypass Graft surgery) or commonly known as bypass surgery.Coronary Artery Bypass Grafting (CABG) is a surgical procedure done to create a 'bypass' around the blocked part of a coronary artery (blood vessels that supply blood to the heart) to restore blood supply to the heart muscle. The bypass is made with the help of blood vessels (known as grafts taken from the other parts of the body (leg, hand, chest wall, etc.)


http://en.wikipedia.org/wiki/Coronary_artery_bypass_surgery


Why and when is a bypass done?When one or more of the coronary arteries becomes partially or totally blocked, the heart does not get adequate blood supply. This is called an ischemic heart disease or Coronary Artery Disease (CAD). It can cause heart pain (angina) or a heart attack (myocardial infarction).CABG is one of the treatment options for ischemic heart disease. Bypass surgery is advised for:1. Disease of the left main coronary artery2. Significant, multiple blockages in all three main vessels of the heart3. Failure of angioplasty4. When the efficiency of the left ventricle is reduced to less than adequate.



How is the surgery done?Before the surgeryOnce the patient has been diagnosed with a triple vessel disease and has been advised to undergo a bypass surgery he has to plan accordingly.For a bypass surgery a stay in the hospital of approximately 10 days is expected with a recovery time of a month after the surgery to get back to the normal routine.



The pre-operative investigations include the following:• Blood tests: includes CBC, Serological tests, blood grouping,

blood sugars, • Urine tests: creatinine, electrolytes• Chest x-ray• Ultra sonography• Carotid and radial Doppler studies• 2D Echo• CT angiography of the internal mammary arteries• Sputum and nasal swabs to check for any active infections

in the body• Lung function tests



Preparing the patient: • On the day of surgery the patient is given medicines to

reduce anxiety and then rolled into the Operation Theatre (OT)

• Electrodes connected to ECG monitor are attached to the patient’s back to monitor the heart’s activity during the operation

• Intravenous lines are then inserted into the veins of the wrist or arm for administration of medicines and salt solutions

• One IV line is threaded up the vein all the way to the vena cava ( the biggest vessel that carries impure blood from all the parts of the body to the heart) to allow administration of medication directly to the heart.



Surgery: • For the surgery, first the chest is cut open at the mid line of

the breast bone ( sternum) and the sternum is separated.• Then the internal mammary artery to be used for the surgery

is separated from the chest wall gently.• Then the surgeon will work on the patients limbs to remove

the vein or the artery.• After this the grafting of the conduits is done.• After several hours of grafting the chest closure is done in

layers.• The patient is then shifted to the ICU



However, in a beating heart surgery the heart lung machine is not used and the surgery is performed on a beating heart. This method is know as an Off-Pump Coronary Artery Bypass surgery (OPCAB) or beating heart surgery.It allows the bypass to be created while the heart is still beating by using a device known as 'octopus'. The advantage is a quicker recovery, fewer complications and better long term outcome, especially in elderly patients and in patients with problems like kidney failure, previous brain strokes, etc. Asian Heart Institute is one of the few centers in the world that specializes in this type of surgery, performing nearly 100% of its bypass surgeries on a beating heart with a very significant percentage using total arterial grafting.


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Redo bypass surgeryA second or redo bypass surgery is needed if blockages develop after the first surgery. It is complex and risky because after surgery, the heart and lungs stick to the breast bone. A beating heart surgery using arterial grafts reduces the risk of a redo bypass surgery. At Asian Heart Institute redo bypass surgery is also performed 'Off-Pump', thereby suggesting the competence of the team.



Frequently Asked Questions After Bypass Surgery1. When can I drive on my own?It is wise to wait for 2 months after surgery, before driving on your own. This is the amount of time it takes for the healing of your sternum (breast bone), which was cut open during surgery. Any chance injury, can cause damage if driving is started too early. Please consult with your surgical team before undertaking any activity after a bypass. 2. Can I travel by car?Yes. You may travel by car as soon as you are discharged. However, for the first few weeks, it is advisable to restrict your travel to less than two hours. If the drive is going to be longer, then take a break every two hours and walk around for a few minutes.



3. Should I speak less?There is no reason for you to 'speak less' after surgery. However, during the first few days of your recovery, you might feel short of breath while speaking for a long period of time. If so, your body is telling you to rest, and your may keep silent for some time.4. Will eating curd or watermelon affect the stitches and slow down the healing of the breast bone? No. Eating curd or watermelon has no effect on your stitches and healing process.



5. When can I start climbing the staircase?If there is an elevator, there is no need to climb stairs just for the sake of exercising. If you do not have an elevator and have to take the staircase, you can do so as soon as you are discharged. While climbing, pace yourself. Take a minute's rest after climbing 10-12 steps during the first week after discharge. As your walking capacity increases, there is no restriction on climbing steps, as long as you do not run out of breath.6. When can I go back to work?It is advisable to wait for at least 2 months after surgery before returning to work. However, depending on the condition of your heart, you may be able to start light work after a month. Please consult with your doctor before returning back to work.



7. What about the blockages in the arteries, will they remain?The blockages which are present is the arteries remain as they were. The 'graft' which provides the 'new blood supply' is connected below your old blockages, thereby providing adequate blood to the heart muscle.8. After my surgery, why do I still feel pain in my chest?To perform your surgery, your chest-bone was cut open and stitched together after surgery. It is quite normal to feel some pain or altered sensations in your chest region for a few months after surgery. However, this pain will be different from the pain of 'angina' which you might have experienced before surgery.



The AHI AdvantageThe latest trend in healthcare is to have lesser invasive surgeries, i.e. surgeries which involve minimal cuts & ensure that patient has a faster recovery. Keyhole or Minimally Invasive Surgery (MIS) is a modern innovative surgical technique that reduces the patient's post-surgery distress & allows them to return back to their normal life in just a couple of days. In Minimally Invasive Surgery (MIS) is a modern innovative surgical technique that reduces the patient's post-surgery distress & allows them to return back to their normal life in just a couple of days.


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Recovery/ Prognosis:Recovery from the surgery takes time. The patient who has received a CABG can expect considerable relief from symptoms and in many cases, increase life span. It should be remembered however that the graft vessels are subject to fatty blockage at any increased rate, so care must still be taken to reduce the risk factors that cause the original blockage.



You can do many things to reduce the risk factors like:• Not smoking• Regular exercising• Control of vitals like Blood Pressure, sugar levels, cholesterol levels etc• Rectification of other clinical conditions if any

Related Tags: Best cardiac arrest treatment | Hospitals for cardiac arrest treatment | Best cardiologist for angioplasty


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