Visualise a road which is hit by a natural disaster, restricting all the movement. The authorities then redirect the traffic around the blocking. Now, your car is back on the clean-unblocked road. The movement is smooth, steady and speedy. This scenario is similar to bypass surgery.
In the actual situation, the coronary arteries (a type of arteries) which supply oxygen filled blood to the heart gets blocked by a waxy substance called plaque. It results into several heart diseases which could lead to heart failure. Here, the surgeon replaces the blocked, damaged artery(ies) with a healthy artery taken from another part of your body. This process is heart bypass surgery, also known as CABG: coronary artery bypass grafting.
The result is an increased and desired supply of blood and oxygen to the heart, with a lower risk of heart attack and other problems.
Is bypass surgery needed at all?
Over a period the coronary arteries in the heart get clogged by plaque, which is a combination of fatty substances, cholesterol, calcium, clotting material in the blood and cellular waste, which leads to unwanted thickening of the walls of the arteries. The thickening narrows the width of the artery, leading to reduced blood and oxygen supply to the heart.
This can be the cause of one or more of the following conditions, which could eventually be the reason for a fatal heart attack:
- Shortness of breath
- Angina, commonly known as chest pain
- Irregular heartbeat
- Blood clotting
Bypass surgery treats these symptoms. Your doctor will recommend the surgery when the blockage of the arteries cannot be treated by medication or other procedures.
How is the bypass surgery performed?
Pre-Surgery
Before the operation, you will have to put on a surgical gown. An intravenous line (IV) will be put in, through which anaesthesia and other medications will be given. It helps you relax, and you will fall asleep for the period of the operation. An antiseptic solution on the skin of the centre of the chest and around it will be applied.
The Bypass Surgery
The cardiac surgeon will remove a healthy artery or a vein from your chest, arm or leg. The incision made will be stitched and bandaged carefully.
The doctor will then move to the actual procedure. He will make a vertical incision in the centre of your chest, separating the skin and the tissues, and exposing the breast bone. The doctor will carefully divide the breastbone, revealing the heart. You will then be connected to a heart-lung machine which will temporarily perform the function of the heart and the lungs, i.e., circulating the oxygenated blood through your body. It will allow your doctor to meanwhile, operate on your heart.
Now is the time to fix the actual problem. Your doctor will take the removed-new healthy blood vessel and attach its ends on either side of the blocked area(s) of the old blocked artery. The attaching of the new artery in this way creates a new route for the blood to travel to your heart effortlessly. For multiple blockages, your doctor may do more than one bypass procedure during the same surgery.
On completion, your doctor will use electrical signals to restore the heartbeat to enable the heart to operate on its own. Once the heart beats regularly, you will be removed from the heart-lung machine. The doctor will wire the breastbone back together, stitch the skin incision and bandage it.
Post-Surgery
Your doctor will get you moved to the intensive care unit where your progress will be monitored for few days. You will continue to have a tube in your mouth for few hours to help you breathe easily.
You will be connected to few machines through which your doctor will monitor heart rate and blood pressure round the clock. It will continue for few days before you are discharged from the hospital to get back to normal life.
How is the Recovery?
It’s not a one-day pop-up, but a gradual healing process. You may not feel too good and lively immediately after the surgery, and this is normal. You will begin to recover day-by-day and feel better. The end-to-end healing process will take about two months, following your doctor’s instructions will help you in your recovery.
Your doctor will ask you to visit him frequently in the initial few months to keep a track on your improvement. However, you need to immediately call him at the slightest discomfort.
Short term effects
It’s obvious that there would be immediate after effects, post the surgery. It could vary from short term memory loss, confusion, to inability to track time. Do not worry, as all of this would take place while you are in the intensive care unit under the close supervision of your doctor.
Before discharging you, the medical team will advise you on the medications which you should take orally, care of the incision wounds, temporary changes required in lifestyle like the amount of rest required, no physical activity, etc., and your next visit to the doctor.
As a thumb rule, you should avoid exertion, heavy physical activity, no driving, not even lifting weight equal to five kilogrammes.
Long-term Effects
The bypass surgery is sure to fix your blocked artery. However, it is critical for you to make habitual changes to prevent any damage in the future. It will include dietary and other lifestyle related changes which you should ask your doctor, if not advised.
On improvement, you will experience a positive change. You will be more active, with a much lower risk of getting a heart attack. It’s about adding years to your life.