About Heart Bypass

Overview

If your circulatory system can no longer deliver the necessary blood, nutrients and oxygen to your body, you may be at a high risk for a heart attack or stroke. If lifestyle changes and medication have failed to help, you may need to consider surgery. Having bypass surgery can be one option to help lower your risk. You need to talk to your doctor and get all the facts before any type of surgery. Knowing what to expect can help you prepare for your procedure and help you avoid complications afterward.

Identification

Heart bypass surgery is also called coronary artery bypass grafting (CABG). Your coronary arteries supply your heart muscle with blood. Your heart needs blood and oxygen to function correctly. If you have too much cholesterol in your blood then plaque can build up on the artery walls and narrow the space through which the blood travels. This restricts the amount of blood and oxygen the heart receives. When the heart is starved for oxygen, the cells can die and you may have a heart attack. The American Heart Association states that bypass surgery can bypass the blood around the narrowed arteries thereby improving blood flow to the heart and reducing your risk for a heart attack.

Features

During bypass surgery your surgeon takes part of a healthy artery from another area of your body. The artery that is cut is then rejoined. The piece of healthy artery is attached to the blocked artery above and below the blockage. Next a piece of healthy vein is taken from another area of the body, usually the leg. This healthy vein is attached to the narrowed artery above and below the blockage. The blood flow is rerouted to flow through the newly attached vein and artery to increase blood flow to and from the heart. Your doctor can perform one, two, three or more bypasses, depending on how many blockages you have. The process of attaching new veins and arteries is called grafting.

Types

There are different types of CABG depending on the severity of your condition. Traditional coronary artery bypass grafting is the most common type. Your heart is stopped during surgery and a heart-lung machine helps deliver blood and oxygen to your body during surgery. After surgery, the heart is restarted using mild electric shocks. Off-pump coronary artery bypass grafting means that the heart is not stopped and the machine is not used. The third type is minimally invasive direct coronary artery bypass grafting. This procedure is used when bypassing the vessels located to the front of the heart. The last two options are less invasive and may be appropriate when there is minimal damage to the arteries or if only one artery is clogged.

Recovery

The American Heart Association states that most patents will remain in the hospital for four to six days after surgery. Longer stays are sometimes needed depending on your recovery. You will then need to go through a period of supervised cardiac rehabilitation to regain your strength and learn how to avoid future complications. You will need to adopt healthy eating habits by limiting your fat, cholesterol and salt consumption and make exercise a part of your daily life. Most patients can eventually return to work and an active lifestyle. Recovery time depends upon your physical health and the type of surgery performed.

Warning

According to the National Institutes of Health, bypass surgery is usually safe and complications are rare. Most of the complications are the same as for any type of surgery such as those that occur due to anesthesia. Rare complications include kidney failure, blood clots in the legs, abnormal heart rhythms and infection. You and your doctor will need to discuss your risk of complications, how to avoid them and weigh out the pro and cons of having surgery.

Considerations

The National Heart, Lung and Blood Institute states that while bypass surgery is common, the first step should be to treat your condition with more conservative approaches. Surgery should be reserved for cases where there is severe blockages in your coronary arteries and when the heart muscle has become weakened. However, they go on to claim that after surgery "85 percent of people have significantly reduced symptoms, less risk for future heart attacks, and a decreased chance of dying within 10 years following the surgery." Lifestyle changes do need to be made in combination with the surgery to make it effective long-term; if the new arteries and veins become blocked, you may need additional surgery.