Coronary artery bypass graft, or CABG, surgery carries several serious complications. The body must sustain several hours under general anesthesia and the heart, in most cases, is stopped and restarted during the surgery. In addition to the risks placed on the heart, all organ systems endure some level of compromise during a CABG. Surprisingly, this surgery also carries some psychological effects that may not manifest until weeks after the procedure.
Bleeding
Bleeding at the site of the graft is a serious complication of coronary artery bypass graft surgery. One of the first signs of an internal bleed is a dramatic change in the vital signs of the patient. A severe drop in blood pressure and increase in heart rate alerts the post-op staff monitoring the patient. In the case of a suspected bleed, the operating room staff reconvenes and the patient returns to surgery. The use of heparin as a prophylactic clot buster medication can also cause a bleed in CABG patients.
Heart Attack and Stroke
A heart attack or stroke may occur during the bypass surgery or afterwards in post-op. The greatest hardships on the heart are the stopping of the heart to perform the grafting, and restating the heart, which reperfuses the heart's chambers with blood.
The release of tiny emboli due to clamping of blood vessels and release after the grafts are completed, have a 1.5 percent chance of causing a stroke, according to the Merck online manual.
Kidney Failure
Although all organs of the body can have a marked reaction to bypass graft surgery, the kidneys appear particularly vulnerable. Possibly stemming from the effect the bypass machine has on the blood's platelets and heparin medication used to break up clots, the kidneys' ability to make and concentrate urine is closely monitored after coronary artery bypass surgery, reports The Merck Manuals Online Medical Library. Patients with previously existing kidney problems have an increased risk of kidney failure after bypass surgery.
Heart Arrhythmias
Atrial fibrillation, characterized by a rapid and sustained heart rate of more than 130 beats per minute, appears in less than half of patients who have undergone a coronary artery bypass graft, reports The Merck Manuals Online Medical Library, and nearly 50 percent of patients suffer a "nonsustained ventricular tachycardia," when the heart beats at a rate between 100 to 250 beats per minute. These arrhythmias can be a dangerous complication to a CABG procedure, and the patient's heart rate is monitored continuously for several hours after heart surgery.
Depression
Although the exact cause of a depression complication following bypass graft surgery is unknown, patient teaching includes an expectation of short-term depression that may develop weeks after the surgery, according to Judith Schilling McCann in the book "Cardiovascular Care."
In a "New York Times" article on depression after bypass surgery, Dr. Ray John of the New York University Medical Center states that post-bypass depression may be due to dislodged arterial plaque that travels to the brain. More studies are needed to determine the exact cause of the post-op depression.
Death
A CABG is a lengthy procedure that typically lasts five to seven hours. The patient, subjected to general anesthesia for hours, the heart stopping and starting, and the hardship placed on all organ systems may be more than the body can bear. The risk of death due to heart bypass surgery can be as high as three percent, states The Merck Manuals Online Medical Library.
References
- Merck: Coronary Artery Bypass Grafting (CABG)
- 'New York Times"; Facing Up to Depression After Bypass
- "Cardiovascular Care Made Incredibly Easy"; Judith A. Schilling McCann, R.N., M.S.N.; 2009
