Coronary arteries supply the heart with the oxygen it needs to continue to pump blood to the rest of the body. When coronary arteries narrow or clog, a doctor might recommend coronary bypass surgery to create a detour around the damage and restore adequate blood flow to the heart. In a triple bypass, the surgeon creates detours around three of the coronary arteries.
Indications
Coronary bypass surgery reduces the risk of a heart attack, which occurs when the heart stops beating rhythmically because of an inadequate blood supply to its muscle cells. According to MayoClinic.com, when more than one coronary artery is blocked, a doctor might recommend bypass surgery rather than angioplasty or stenting to restore adequate blood flow. For patients with damage to three of their coronary arteries, a triple bypass might be the best solution.
Procedure
In a triple bypass surgery, the surgeon reroutes blood flow from the damaged coronary arteries through grafted sections of healthy blood vessels taken from the patient's lower leg or chest wall. In the most common procedure, the surgeon opens the chest, temporarily stops the heart and routes blood flow through a heart-lung machine, says MayoClinic.com. After harvesting the healthy blood vessels, the surgeon attaches one end above the area of damage and the other end below the area of damage for each of the three coronary arteries. Once all of the grafts are secure, blood is directed back into the heart. According to the National Heart, Lung and Blood Institute, or NHLBI, a newer procedure that avoids use of a heart-lung machine might be appropriate for triple bypass, but minimally invasive techniques using smaller incisions are not.
Risks
Triple bypass surgery is a major operation with the usual risks of a bad reaction to anesthesia, heart attack or stroke during or after the procedure, and post-operative infection. Weeks after the surgery, the heart sac, or pericardium, can become inflamed and retain fluid, which requires treatment, according to the NHLBI. In addition, the NHLBI says that using a heart-lung machine increases the risk of blood clots. In a triple bypass, the surgeon often uses both arteries and veins as grafts. The NHLBI says that vein grafts are more likely to develop blocks over time.
Recovery
After triple bypass surgery, patients typically spend one or two days in intensive care followed by another three to five days under general hospital care. The NHLBI says to expect up to 12 weeks for full recovery, although most patients can resume work about 6 weeks after the procedure.
Success
According to the NHLBI, after bypass surgery, 85 percent of patients have fewer symptoms, a decreased risk of having a heart attack and a decreased risk of dying within 10 years. MayoClinic.com says that patients can remain symptom free for up to 15 years.
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