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Overview

Bypass Surgery: Procedure, Recovery, Cost, Risk & Complication

Bypass surgery refers to a surgical procedure that helps in diverting the blood flow around a blocked or partially blocked artery of the heart. It is done to create a new pathway to the heart and improving the flow of blood to the heart muscle. During this surgery, a healthy, well-functioning blood vessel is taken from the arm, chest or leg and then connected to the other arteries in the heart so that the blood can bypass the blocked or the diseased area.

Problems such as shortness of breath and chest pain, due to poor flow of blood tend to improve after a bypass surgery. It may also improve the heart function and reduce the risk of a heart disease.

Indication

One may require a bypass surgery in the following cases:

  • Suffering from severe chest pain that is caused due to the narrowing of the arteries that supply blood to the heart muscle
  • If more than one coronary artery is diseased, and the left ventricle is not functioning well
  • The main coronary artery in the left is narrowed or blocked, as this artery supplies the maximum blood to your left ventricle
  • An artery blockage that cannot be cured by angioplasty or a previously done angioplasty or stent placement has been unsuccessful
  • Restenosis, which involves the narrowing of the artery even after a stent replacement
  • In case of emergency situation such as a heart attack, where the patient does not respond to other treatments

Pre Procedure

The following preparation needs to be taken in before undergoing a bypass surgery:

  • Your doctor will provide you with the initial instructions regarding restrictions in any particular activity or changes in your diet and medicine.
  • Pre-surgical tests such as x-ray of the chest, blood tests, coronary angiogram and electrocardiogram will be conducted.
  • In most cases, a patient is admitted to the hospital in the morning of the surgery. It may also be performed in emergency conditions like just after a heart attack.

During Procedure

The procedure of a bypass surgery involves the following steps:

  • The time taken is normally 3-6 hours, and the surgery can be performed with general anaesthesia
  • An incision is made in the chest, while diverting the blood flow with the help of a heart-lung machine. The rib cage is spread opened by the surgeon, exposing the heart. The heart is made to stop working for the time being, while the heart-lung machine circulates the blood in the body.
  • The healthy blood vessel is then attached above and below the blocked artery, making sure that blood flow will bypass the narrowed part of your diseased artery.
  • A breathing tube, inserted in your mouth helps you to breathe during and post-surgery.

Post Procedure

Since bypass surgery is a major operation, you may be admitted in the ICU for one or two days while your blood pressure, breathing, heart and other vital signs will be monitored. The breathing tube remains in the throat till the time you gain consciousness and can breathe on your own. If you do not have any complications, you are likely to be discharged within a week. Initially, simple tasks like walking or your daily jobs may become difficult to perform. Consult your doctor if you face any of the following symptoms that indicate an infection of your wound:

  • Fever
  • Rapid heart rate
  • Pain around the wound in the chest
  • Reddening, bleeding or other discharge from the area of the wound

Risk & Complication

The risk of a complication is generally low in a bypass surgery, though it depends on your overall general health before the surgery. The risk factor will be higher if the surgery was done in an emergency basis, or if you have serious health conditions like kidney disease, diabetes, blocked arteries in the legs or emphysema (lung disease).

The possible risk and complications associated with a bypass surgery are:

  • Bleeding
  • Arrhythmias, improper beating of the heart
  • Infection of the wound in the chest
  • Stroke
  • Problems in the kidney
  • Memory loss or facing trouble when thinking clearly that generally improves in 6 months
  • Heart attack, in case a blood clot breaks loose just after the surgery

More Info

Post surgery, a patient stays well and free from any symptoms for the next 10-15 years. It is likely that the graft that has been used gets clogged eventually after a prolonged time period, requiring another bypass surgery or angioplasty. Apart from taking your medicines timely, it is important to make certain changes in lifestyle like quit smoking, maintain a healthy diet and weight, exercise on a regular basis and manage stress. Cardiac rehabilitation is another customised programme of education and exercise that helps to recover after a heart surgery.

The cost of a bypass surgery would be approximately Rs. 1,50,000 – Rs. 3,50,000.

Popular Health Tips

Open Heart Surgery - Things You Must Know About It!

Dr. Kewal Krishan 83% (10 ratings)
MCH DNB (CTVS), Advanced fellowship, MS
Cardiologist, Delhi
Open Heart Surgery - Things You Must Know About It!
Open heart surgery is a complicated heart procedure. Although the number of open heart surgeries performed over the past has decade has reduced significantly, howeevr, it is still an important surgical procedure to fix critical heart ailments. Here is a quick fact-checker about this procedure: The Coronary Artery Bypass Graft or CABG is one of the frequently performed procedures in the open-heart surgery space. This is a procedure that is related to fixing the blocked arteries of the heart. A study conducted by the National Institutes of Health revealed that most patients who had undergone CABG become angina-free within a span of five years. Many hospitals refuse to share any data related to the surgery. It makes sense to run a background check on the surgeon who is scheduled to perform the procedure. Society of Thoracic Surgery lists all doctors and the number of procedures they have performed in this space. This is one of the few surgeries where a doctor needs to make a deep incision close to 2-2.5 inch through the breastbone to separate muscle and get access to the heart. The patient is hooked to a heart-lung machine before the proceedings begin. This machine pushes blood to the body. It helps the doctor to stop the heart and perform the procedure. Once the procedure is over, the doctor closes the incision made through the breastbone with sternal wires. Then the surgeon gives a minor electric shock to the patient to restart the heart. Subsequently, the patient is taken off from the heart-lung machine. The patient might find himself tangled with many tubes as he wakes for the first time after the surgery. These wires take the fluid out of the body. They serve as a temporary pacemaker for the patient. It is important to get a clarification from the surgeon as to from which location of the body would the veins be taken from to perform CABG. Most doctors prefer the vein from the leg. However, recent studies have shown that veins can be extracted from the internal chest wall. This results in a speedy recovery for the patient. The patient is kept in an ICU for a couple of days before he is shifted to the general ward where he spends close to a couple of weeks before he is released. After the patient gets home, the typical recovery time for the patient is approximately 6-8 weeks. One has to usually deal with heightened emotions after an open-heart surgery. Studies have shown that over 20 percent of the CABG patients suffer from depression, anger, and other emotional problems. This typically lasts for a year till everything becomes normal.
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Gastric Bypass Procedure - Precautions and Associated Risks!

Dr. Premkumar Balachandran 86% (12 ratings)
MBBS, MS - General Surgery, M.Mas, Diploma In Minimal Access Surgery, Fellowship in Minimal Access Surgery, FRS, FICS, F.I.A.G.E.S, FAMASI
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Gastric Bypass Procedure - Precautions and Associated Risks!
The risk of developing heart problems has increased to a great extent and this is mainly due to obesity, which leads to other diseases. A gastric bypass surgery is a medical procedure, which is commonly known as Roux en-Y surgery. It aids in reducing the size of the stomach. The reduction in the size of the stomach makes an individual feel full even when they have eaten very little. Gastric Bypass Procedure The stomach bypass surgery is generally known as a bariatric surgery and it guarantees weight loss of about 30-40% within a year. For this procedure, the patient has to be in the hospital for 4-5 days and it takes about 2-3 hours for the medical procedure. It is through this procedure that the size of the stomach is reduced permanently and is performed laparoscopically. Five small holes are made in the stomach under general anaesthesia. The procedure is conducted only after tests like ECG, blood and urine tests, chest X-Ray chest, abdominal scan and echocardiogram are carried out. The patient can be discharged from the medical centre on the fourth day. However, it is necessary that calcium, vitamins and supplements are included in the diet plan, mainly to prevent malnourishment and tiredness. In the medical procedure, the surgeon divides the stomach into two sections using surgical staples. The sections are divided into a small upper pouch and a large remnant. The medical procedure makes use of surgical staples, which is why the procedure is sometimes referred to as stomach stapling. The small intestine is re-arranged in a manner that the stomach pouches are connected to the intestine. The intake of food is reduced by the reduction in the functional capacity of the stomach and by the re-arrangement of the small intestine that causes food to go through the first portion of the small intestine. The procedure is mainly targeted for people with body mass index of 50 and above. It is important that the individual should not drink water for next 24 hours of surgery. Benefits of Gastric Bypass Procedure Results in reduced calorie absorption and helps in weight loss. It is generally advised for people who are unable to accomplish weight loss through diet and exercise. Risks involved in gastric bypass procedure Inflammation of the stomach lining Nausea and vomiting Bleeding Nutritional deficiency Development of gallstones. This occurs mainly due to loss of significant weight within a short span of time. The procedure is a little expensive, but it is a reliable medical procedure for weight loss. It is always better to know about the risks involved in this surgery before opting for a weight loss program. Consulting a practitioner is very important to know whether you are fit for the medical procedure.
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Coronary Artery Disease - How Medications Can Help You Treat It?

Dr. Tejas V Patel 91% (12 ratings)
DM - Cardiology, MD - Medicine, MBBS, Observership
Cardiologist, Ahmedabad
Coronary Artery Disease - How Medications Can Help You Treat It?
Coronary artery disease is one of the major killer diseases of the modern society. It is not a solitary problem but brings with it a multitude of issues including obesity, diabetes, stroke, and other metabolic disorders. A thorough understanding of what causes it and how to manage it can help save thousands of lives. Causes: The circulatory system is mainly made up of the heart and a complex network of arteries and veins. The inner walls of these are lined with smooth muscles, allowing for free flow of blood. Gradually, over a period of time, given the density, the fat from the blood flowing through these vessels settles along the walls of these vessels. This attracts more fat, lipoproteins, and other inflammatory cells and so the process continues. This reduces the diameter of the blood vessels, therefore reducing the amount of blood supply to the target organs. If the target organ is a vital one like the brain or the heart, then it could lead to stroke or heart attacks. Main causes for coronary artery disease include high blood pressure, high cholesterol, sedentary lifestyle, obesity, smoking, diabetes, and stress. Men are more prone than women, and family history and age puts them at higher risk. Symptoms: Reduced blood supply to the target organ causes the following symptoms: Shortness of Breath: A person with coronary artery disease will feel short of breath and tired with most activities, even like walking a few meters. Chest Pain: A strong pressure sensation on the left side of the chest is an indication of coronary artery disease. Known as angina, it comes with stress and goes away once the stress is removed. It could sometimes radiate to the shoulder, down the arm, or up into the jaw also. These are classical symptoms of angina or heart attack and is considered an emergency. Of note, this is often mistaken for indigestion. Palpitations: A sensation where you are able to hear your heartbeat. Nausea and Excessive Sweating: Nausea and excessive sweating are also seen during angina. Treatment: There are 3 modes to manage this. Medications: Aspirin to reduce the viscosity of the blood. Statin to control the cholesterol levels. Beta blockers to control hypertension. Nitroglycerin for temporary relief of angina pain. Surgical Procedures: Surgical procedures including balloon angioplasty followed by placement of drug-eluting stents and coronary artery bypass surgery are done to manage more severe cases. Lifestyle Change: Lifestyle changes including reduced fat consumption, decrease body weight, stop smoking, increased physical exercise, and reducing stress are highly important in preventing further damage. Once suspected, coronary artery disease can be effectively managed and the extent of damage controlled using the above techniques.
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Alcohol & Gastric Bypass - Can They Be Mixed?

Dr. B N Shukla 86% (22 ratings)
Fellowship in Minimal Access Surgery, Fellowship in Bariatric Surgery, M.S.
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Alcohol & Gastric Bypass - Can They Be Mixed?
Gastric bypass, one of the weight loss surgeries bring about many changes and alterations (physiological, metabolic, hormonal) in your body. The gastric bypass surgery rearranges the stomach into an upper pouch (the smaller part) and a relatively larger lower part. It is the small pouch that is connected to the small intestine, where the absorption of nutrients and minerals from the ingested food takes place. The surgery plays a significant role in limiting the intake of food. Thus, post-surgery, a person's body reacts differently than it used to before the surgery. Many, if not all, people experience difficulties in coping up with the changes. Patients are often advised to refrain from alcohol consumption after the gastric bypass surgery. Surprisingly, and quite alarming, cases of alcohol abuse increases post the surgery. According to a survey by the American Society for Metabolic and Bariatric Surgery, few people, who had no prior history of alcohol abuse developed one after the weight loss surgery. What triggers the alcohol abuse in some patients is still a debatable issue. Many patients experience an emotional breakdown, stress, anxiety, and depression after the surgery. People who needed no reason to binge on food are suddenly expected and made to consume a limited quantity of food. Unable to do what they loved doing the most, people look for an alternate solution. As expected, in most cases, alcohol becomes the much-needed solution. What started as a means of distraction gradually becomes an integral part of life. Hormonal changes associated with the surgery can also result in panic attacks, stress, and anxiety. Incidences of alcohol abuse may also be high in patients who had a history of drinking (regular or occasional) and smoking before the gastric bypass. Under normal circumstances (before the weight loss surgery), there is a partial enzymatic breakdown of the consumed alcohol in the stomach before it passes into the small intestine. However, post-surgery, the small size of the stomach does not facilitate such enzymatic breakdowns. Thus, the alcohol passes into the intestine, where it gets rapidly absorbed. As a result, a person gets into an inebriated state at a faster rate. It is because of this reason that doctors advise the patients to keep away from alcohol as much as possible after the surgery. To keep away from or reduce the instances of alcohol abuse after the gastric bypass surgery, Look for healthier and low-calorie food options when you get an urge to eat. Meditate, go for morning and evening walks. These physical activities act as great stress busters. If you are feeling low or going through an emotionally low phase, share it with your loved ones. Do not suppress your emotions. Consult your attending physician in case of any physical discomfort
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Coronary Artery Bypass Grafting (CABG) - Know Its Benefits!

Non Invasive Services
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Coronary Artery Bypass Grafting (CABG) - Know Its Benefits!
Coronary Artery Bypass Grafting (CABG) is a traditional and well established surgical procedure for treating diseases in the coronary artery. The process is carried out by using blood vessels alternately (vein or artery). Initially, CABG was performed by using the left internal mammary artery and saphenous vein. It was observed that the chance of occlusion in the vein grafts was much higher than the arterial grafts. In the last decade, total arterial grafting, which uses all the arterial conduits, is being practiced as CABG for better results. Types of Coronary Artery Bypass Grafting Traditional Coronary Artery Bypass Grafting: In this type of CABG, the surgeon will initially open up the chest bone to gain access to the heart. The heart is stopped using medications and the body is connected to a heart-lung bypass machine to circulate oxygen and blood throughout the body. Minimally invasive direct coronary artery bypass grafting: In this surgery, small incisions are made on the left portion of the chest to gain access to the heart. This surgery is used to bypass the blood vessels present in the front portion of the heart. Off-pump Coronary artery bypass grafting: In this procedure, the chest bone is opened up to access the heart. Here, however, the heart is not stopped during the surgery. Patients, who have been suffering since a long time and have been operated on the vein grafts, have a chance of re-developing certain artery diseases such as a heart attack. To counter this possibility, surgeons have started using the method of Total Artery CABG. In this procedure, the left and right internal mammary arteries are used from the chest and the radial artery, from the fore arm for the surgery. The main advantages of this procedure are: The survival rate is higher in total artery CABG as compared to the traditional CABG. It comes with long term benefits The procedure is safe as well as feasible
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Popular Questions & Answers

Dr. korandil 5 mg tablet used for what purpose I have gone bypass and taking korandil 5 mg.

Dr. Paramjeet Singh 95% (797 ratings)
MBBS, Dip.Cardiology, Fellowship in Clinical Cardiology(FICC), Fellowship in Echocardiology
Cardiologist, Ghaziabad
It has nicorandil which is a vasodilator it deletes the blood vessels supplying blood to your heart and thereby relieving temporary if there is any significant blockages.
1 person found this helpful

My weight is 99.3 and I am diabetic. High blood pressure. I want to know is there a ring surgery possible in my case without any risk. Or any other help for me.

Dr. Garima Sharma 92% (391 ratings)
MBBS
General Physician, Delhi
Hi Lybrate User, You don't need surgery to lose weight. Just few steps and you can live a healthy life. The two essentials to maintaining a healthy weight are: Eating well & Moving often. Increasing activity in order to lose weight If your doctor recommends that you lose weight, there’s a simple rule to follow: move more, eat less and make smarter food choices. Gradually increase your level of physical activity beyond 150 minutes of moderate-intensity aerobic activity, lower the number of calories you take in and eat a healthy diet. Once you’re at your goal weight, you can then determine which dietary and fitness choices work best for maintaining your weight.

My father has gone through heart bypass surgery in july16. Currently all his reports are normal and doing well. Have read red wine is good for heart, is it advisable for him to consume 750 ml in a month. Plse advise.

Dr. Nazima 85% (1397 ratings)
MD PHYSICIAN
General Physician, Delhi
Light alcohol consumption was associated with a 25 per cent reduction in additional heart procedures, heart attacks or strokes. However, the study found heavy-drinking bypass patients - those who had six or more drinks a day - were twice as likely to die from heart problems. So the intake should be in moderate volume.

I have undergone bypass surgery in the year 2015 n in the month of December. Can I consume chicken and mutton lever? I have checked my cholesterol level which is below normal.

Mr. Mangala Roy 89% (390 ratings)
Master of Hospital Administration, DTM&H, MBBS
General Physician, Kolkata
Mutton is better than chicken, specially for heart disease, however too costly, it is your jurisdiction.
1 person found this helpful

Health Quizzes

Dealing With Coronary Artery Disease

Maxcure Hospitals 85% (10 ratings)
Multi-Speciality Clinic
Cardiologist, Hyderabad
When it comes to dealing with coronary heart disease through a surgical approach, there s no minimally invasive method available. True or False. Take this quiz to know now!
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