Coronary arteries are the narrow blood vessels that supply the heart and may get partially or totally blocked, producing symptoms like angina, chest pain, heart attack, etc. Coronary artery bypass surgery is a surgical procedure in which the blocked coronary arteries are bypassed using a healthy artery or vein taken from the patient’s body. This restores normal blood flow to the heart, producing relief from the symptoms.
Under general anaesthesia, a 6-8 inch incision is made through sternum (breastbone), rib cage is retracted, exposing the heart. The patient is connected to a heart-lung bypass machine, which supplies blood to the body while the heart is stopped so that the surgeon may operate upon it.
The graft is taken from artery/vein from the leg (saphenous vein), chest (internal mammary artery) or arm (radial artery) of the patient. This graft is attached above and below the blocked area so as to bypass the blockage and resume the blood flow to the heart.
There is also an option of minimally invasive surgery, where smaller chest and graft removal incisions are used, promoting a quicker recovery. Beating heart surgery can be done using equipment to stabilize portions of the heart and bypass the blocked artery while the rest of the heart keeps pumping and circulating blood through the body.
As per the need, upto three or four coronary arteries can be bypassed during surgery.
The length of the procedure depends upon the number of arteries being bypassed, but it generally takes from 4 to 6 hours.
After the operation, patient is kept in ICU for 2-3 days. The total hospital stay is of seven to ten days.
Normal routine of food, walking around,etc is resumed around third day. Cardiac rehab programme is started. Full recovery takes about 6 to 8 weeks. Activities that cause pressure or weight on the breastbone or tension on the arms and chest like pushing and pulling heavy objects, etc is to be avoided. Sedentary job can be resumed within four to six weeks; for heavier activities, waiting for 12 weeks is advised.
The grafts stay open and work well for many years and patients get relief from their problems like chest pain. But this surgery does not prevent the coronary artery from getting blocked again. It is therefore essential to strictly follow the diet, medication and lifestyle modifications as advised by the doctor.
Besides the risk of infection, blood loss, breathing problem; there may be problems like heart rhythm irregularities, heart attack, kidney/lung failure, chest pain, etc.
Choosing the right cardiovascular surgeon can minimize the risks.