Coronary or heart bypass surgery involves a long incision in the chest, so the heart is uncovered. A section of a healthy vessel is then taken and attached above and below the obstructed artery, and therefore, the flow of blood is dissuaded around the constricted portion of the diseased artery. Aided by general anaesthesia and needing between 3-6 hours for the process.
Right after the general anaesthesia, there is a ventilator by the patient’s bed which has a tube inserted into his/her mouth. This helps the patient to breathe during and immediately following the bypass. And just like other major surgeries, a patient’s condition must be carefully monitored, so a day or two in the ICU is required.
An alternative method involves a smaller chest incision, with robotics and video imagining to operate on a small area. This is a minimally invasive surgery, and all of these bypass methods are currently under practice at Apollo Hospitals, India.
Medicines to regulate the circulation and pressure of blood are injected through IV (intravenous) lines inserted into the patient’s arm. Apart from the breathing tube, there are tubes in the chest and the bladder to drain fluid from the chest and urine respectively.
Moreover, a patient may receive oxygen through nasal prongs or masks, and a temporary pacemaker for controlling abnormal rhythms of the heart.
Prolonged bed rests can increase risks of blood pooling and clotting. This is counteracted by the use of compression stockings, tight around the ankle and looser as they ascend the leg, creating gentle pressure up the leg, thus reducing the risks.
Unless the patient regains consciousness and can breathe independently again, the breathing tube is kept in place. Around 3-5 days before being discharged, a patient will be shifted to a less intensive area. Without complications, a patient can expect to return home within seven days, but he/she should not expect to return to a normal daily routine anytime soon. Even walking for a short distance can be difficult.
As with every invasive procedure, an infection can happen, and it must be taken seriously. The patient should return to the hospital as soon as possible if experiencing symptoms of fever, increased heart rate, pain in or around the chest wound which is either new or exacerbated, reddening in the chest wound area or some kind of discharge from the wound. All of these can lead to infection.
All patients are usually given instruction on how to deal with common adverse effects, which can occur around 4-6 weeks post-surgery. Some of the symptoms include discomfort or itching at the incision, swelling in the area where the vessel was removed from, muscular pain or a feeling of tightness in the shoulders and upper back, fatigue, mood swings, depression, sleeping problems, loss of appetite, constipation, chest pain in the region of the sternal incision.
The recovery time is around six to twelve weeks; newer methods take even lesser time. After that, the patient can expect to go back to doing their routine activities besides any demanding physical activity. Make sure that as a patient, you receive prior permission from your doctor, as it is very important.
Periodic checkups include tests to see the functioning of the heart, such as ECG, stress testing, echocardiography and cardiac CT. Patients need to understand that bypass is not the ultimate cure for coronary heart disease. Lifestyle changes such as diet control, quitting smoking, regular exercise, and lowering and managing stress – plays a significant role in staying healthy and preventing the progression of the disease.
Last but not the least, taking medicines regularly as per instructions is important.