According to the Robert Woods Johnson Foundation, 152 thousand coronary artery bypass surgeries were performed in the United States in 2003. Coronary artery bypass surgery requires the surgeon to bypass blockages in the heart arteries to restore blood flow to the heart muscle. This major surgery carries the risk of potentially serious complications.
Stroke
Stroke is a serious complication during early postoperative recovery after coronary artery bypass, and has significant morbidity and mortality. Stroke occurs when a blood clot or piece of atherosclerotic plaque breaks loose from an artery and travels to the brain. According to a 2001 article in the journal "Stroke," the incidence of stroke after coronary artery surgery has a 14 percent higher incidence of mortality versus 2.7 percent for those without a postoperative stroke. The researchers of this study noted that the risk factors for stroke after bypass surgery are diabetes, previous stroke, atrial fibrillation, hypertension, carotid artery disease, chronic kidney insufficiency or heart failure. Stroke after bypass requires intense rehabilitation in nursing facilities.
Cardio-Pulmonary Bypass Machine Complications
Surgeons use the heart-lung machine, otherwise known as the cardiopulmonary bypass machine, to maintain circulation of blood within the body during heart bypass surgery. During the procedure, blood flow to the heart is diverted to the cardiopulmonary bypass machine in order to allow surgeons to operate in a bloodless field. Tubes placed in the aorta and the right atrium divert the blood to the machine, where it is detoxified and oxygenated. Then it is returned to the patient. Because heparin is used in the heart-lung machine to prevent clots, one of the side effects of using this machine is bleeding during the early postoperative course. Renal and acute respiratory failure can occur because the cardiopulmonary bypass machine causes a systemic inflammatory response. The Merck Manuals Online Medical Libraryt also states that patients are susceptible to stroke in the first days after bypass because of the heart-lung machine.
Arrythymias
Arrythmias occur in 15 to 40 percent of heart bypass patients 2 to 3 days after surgery, according to the Merck Manuals Online Medical Library. In order to attach the bypass grafts, the heart must be handled, and this can interfere or damage the electrical conduction system of the heart. Fifty percent of patients experience non-sustained ventricular tachycardia, a fast, chaotic heart rhythm. Atrial fibrillation is another common arrhythmia. These abnormal rhythms are controlled with medications during the hospital stay.
References
- Robert Woods Johnson Foundation: Trends in CABG Hospital Volume
- Stroke.org: Stroke After Coronary Artery Bypass, Incidence, Predictors and Clinical Outcomes
- Mayo Clinic: Coronary Artery Disease: Angioplasty or Bypass Surgery?
- Merck Manuals Online Medical Library: Coronary Artery Bypass Grafting (CABG)
