Thanks to bad lifestyle our blood vessels suffer from the build-up of fatty plaque. Fortunately, the problem of clogged arteries can be solved with bypass surgery, the most common and well-established type of heart surgery.
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The idea is very simple: if arteries are closed, let's make a new path for the blood. Bypass surgery provides precisely that: it improves the blood flow in arteries to the heart with a new route called "bypass". Bypass leads blood around a part of a clogged artery and the full name of that procedure is coronary artery bypass grafting (CABG).
The surgery itself looks like this: the breastbone is divided, the heart is stopped, and blood is sent through a heart-lung machine. After that, a long piece of vein, called graft, from the leg is removed. One end of the graft will be attached to the large artery that carries oxygen-rich blood out of the top of the heart to the body. The other end of the graft will be attached to a coronary artery below the blocked area. This new blood vessel is a new route for blood and the heart again gets the oxygen-rich blood needed to function properly.
Sounds a little bit scary, but it's a straightforward procedure done millions of times. The procedure can take from 2 to 6 hours, depending on the number of bypasses needed. The patient can expect to stay in the hospital one week, including 1 to 3 days in the intensive care unit.
There is also another method called minimally invasive coronary artery bypass. That type of surgery is done through smaller incisions. This minimally invasive procedure may be done without stopping the heart, and some patients can leave the hospital after two days. However, this procedure is only used for patients whose blockages can be bypassed through this smaller incision and with low risk of post-operating complications.
Depending on the state of the blood vessels, there can be a single bypass, double bypass (two coronary arteries are bypassed), triple bypass, quadruple bypass and quintuple bypass. Quintuple bypass is among the rarest cases but not much harder than other cases. It's important to say that a greater number of bypasses does not imply a person is sicker, so if the patient need three bypasses that doesn't mean that he's three times sicker that the one with a single bypass.
Who needs CABG? This procedure is used to treat people who have severe coronary artery disease that could lead to a heart attack. CABG can be recommended when other treatments, such as lifestyle changes or medicines, haven't worked. The doctor will base the decision if the patient is a candidate for CABG on several factors: the severity of symptoms, the severity and location of blockages in coronary arteries, response to other treatments, quality of life, and other medical problems. Sometimes the procedure is performed on an emergency basis, for example immediately after a heart attack.
After bypass surgery the doctor may recommend walking or swimming to get the strength back. He may also recommend joining a cardiac rehabilitation program. These programs can help you make lifestyle changes such as starting a new diet with limited intake of the fat and cholesterol, exercise program, quitting smoking, and learning to better deal with stress. The patient with bypass can live absolutely normal life including moderate sport activities, of course after he got the permission from his doctor.
If the patient has an office job, he can go back to work in 4 to 6 weeks, and those with more physically demanding jobs may need to wait longer. In some harder cases, the patient may need to find a job that is not as physically demanding. Depending on the lifestyle, some 20 to 30 percent of bypass patients will need a second procedure within 10 years. ■
Depending on the state of the blood vessels, there can be a single bypass, double bypass (two coronary arteries are bypassed), triple bypass, quadruple bypass and quintuple bypass. Quintuple bypass is among the rarest cases but not much harder than other cases. It's important to say that a greater number of bypasses does not imply a person is sicker, so if the patient need three bypasses that doesn't mean that he's three times sicker that the one with a single bypass.