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Overview

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

What ois Bypass Surgery?

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

What Procedure is followed :

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

Beating Heart Surgery - What All Should You Know

DM - Cardiology, MD, MBBS Bachelor of Medicine and Bachelor of Surgery
Cardiologist, Ghaziabad
Beating Heart Surgery - What All Should You Know

Beating heart surgery is known to help improve the lives of many individuals each year. The surgery is done on the heart while your heart continues to beat. It is usually recommended in the case of a coronary artery disease.

Beating Heart Surgery or Coronary Artery Bypass Graft Surgery (CABG) or Off-Pump Coronary Artery Bypass Surgery (OPCAB) is a bypass surgery performed on your heart while it is beating. When your arteries cannot supply adequate blood to your heart and other body parts, you are required to undergo a CABG surgery.

Your heart will not be stopped during the surgery and your lungs will continue to function during the surgery to ensure proper blood flow. A tissue stabilization system is used to immobilize the area of the heart on which the surgeon needs to work.

What happens before a beating heart surgery?
A complete health check with chest X-rays, blood work, an electrocardiogram (ECG), and a coronary angiogram is done. The ECG detects the source of the problem. An angiogram is like an X-ray which uses a dye to show all the arteries that supply blood to the heart. These tests help the surgeon decide whether the patient is fit for the surgery and where the blocks are in the arteries.

What happens during a beating heart surgery?
The surgeon cuts a section of healthy vein or artery from a part of your body and treats it. This is the graft that will be used to create a bypass in the blood circulation of the heart. One end of the graft is attached to an area above the artery blockage in your heart. The other end is fixed to the area below the blockage. Once the graft is perfectly attached, the bypass is created and the blood flow to your heart is restored.

The trickiest part in a CABG surgery is to suture or stitch the muscles of the beating heart. Hence, the stabilization system to keep the heart steady during the surgery is used. The stabilization system is made up of a heart positioner and a tissue stabilizer. The heart positioner guides and holds the heart in a fixed position, which provides easy access to the blocked arteries. The tissue stabilizer holds the area of the heart steadily while the surgeon can perform the surgery.

What happens after a beating heart surgery?
While your duration of stay in the hospital may vary depending on the outlook of your surgery, you will be in the Intensive Care Unit (ICU) so as to be monitored throughout the day. Once you are stable and alert, you will be transferred to the room, where you will be taken care of till you are stable to be discharged. Specific instructions on diet, incision care, medications, activity, and other routine will be given. In case you have a concern or query you can always consult an expert & get answers to your questions!

2579 people found this helpful

Bariatric Weight Loss Surgery - How Laparoscopy Can Help In It?

MBBS, MS - General Surgery, FRCS - General Surgery , Fellowship in Minimal Access Surgery
General Surgeon, Delhi
Bariatric Weight Loss Surgery - How Laparoscopy Can Help In It?

Obesity is a serious lifestyle disorder that can trigger a myriad of health complications. You may often come across people who fail to lose an inch even after toiling hard. The situation may be further complicated and life-threatening if a person is suffering from diabetes, hypertension, arthritis or a heart problem. Bariatric Surgery comes as a much-needed relief for people who desperately need to lose weight to prevent health problems. People between 18-65 years of age can go for a Bariatric weight loss surgery. The surgery is also helpful for people with morbid obesity (a condition where the BMI is over 40) with associated complications.

Common types of Bariatric surgeries

  1. The Laparoscopic Gastric Banding: The gastric banding surgery is a surgical weight loss procedure that divides the stomach into two compartments so that a person consumes lesser amount of food.
    • The surgery requires the surgeon to make 3-4 small cuts in the belly.
    • An adjustable silicone band is placed into the stomach (through the small incisions) to divide the stomach into two compartments (a smaller upper half and a bigger lower part).
    • Due to the banding, the stomach can hold not more than an ounce of food, thus limiting the amount of food a person can eat.
    • There is an opening in the band which serves as a passage through which the food eaten is passed to the rest of the stomach.
    • There is a plastic tube that connects the band to an injection port (situated under the skin). It is through this port that saline is either added or removed from the silicone band (to adjust the tightness of the band).
  2. Roux-en-Y Gastric Bypass Surgery (RGB): The bypass surgery also involves compartmentalizing the stomach into an upper half (small pouch, almost the size of a walnut) and a bigger lower part. Like the gastric banding, the rearrangement reduces the amount of food the stomach can hold to a great extent. In the next step, also termed as the bypass step, the surgeon makes a small hole in the pouch to connect it to the small intestine or the jejunum. As a result of the bypass, the food will now directly enter the small intestine from the pouch. While the bypass surgery can be done using laparoscopy, a person can also undergo an open surgery.
  3. Laparoscopic Sleeve Gastrectomy: As the name suggests, the surgery involves excision of a large part of a stomach. The excision leaves behind a small sleeve-like pouch, the arrangement ensuring that a person consumes a lesser amount of food.
  4. Biliopancreatic Diversion: The surgery is risky and is advised only when an individual has a BMI of more than 50. In Biliopancreatic Diversion, the surgeon excises a part of the stomach, while connecting the remaining half to the lower part of the small intestine or jejunum. As a result, a person consumes lesser calories than before. In case you have a concern or query you can always consult an expert & get answers to your questions!
2127 people found this helpful

Open Heart Surgery - Things You Must Know About It!

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.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2450 people found this helpful

Alcohol & Gastric Bypass - Can They Be Mixed?

Fellowship in Minimal Access Surgery, Fellowship in Bariatric Surgery, M.S.
Bariatrician, Lucknow
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 an expert & get answers to your questions!

1872 people found this helpful

Coronary Artery Bypass Grafting (CABG) - Know Its Benefits!

Non Invasive Services
Cardiologist, Mohali
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

  1. 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.
  2. 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.
  3. 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:

  1. The survival rate is higher in total artery CABG as compared to the traditional CABG.
  2. It comes with long term benefits
  3. The procedure is safe as well as feasible

Consult an Expert & get answers to your questions!


 

3404 people found this helpful

Popular Questions & Answers

Kam 68 hr old my bypass surgery was done in April 17 I take medicines given but I sleep only 3 hrs in night pls guide.

DHMS (Hons.)
Homeopath, Patna
Hi, Lybrate user, to check loss of sleep: You should go for a walk in the morning. Go for meditation to reduce your stress to calm your nerves to restore sound sleep. Your diet be easily digestible on time to check gastric disorder that triggers loss of sleep. Maintain your BP and sugar level in order. Moreover, monitoring medication be more essential, please. Tk, care.

Can a person Live long after Heart Surgery? Like Heart bypass Or any Other Heart Operation?

MBBS
General Physician, Mumbai
As per the data available the person will longer if the cause is treated unless until proven otherwise

Hi Sir, Does EECP is better option than 2nd time CABG to my father. He has mild LV dysfunction. Does it harm or danger by this treat meant. His age is 55 and weight 102 kg. He is diabetic,

MBBS
General Physician, Mumbai
EECP is still not a confirmed line of treatment and if symptomatic than plan for a angiogram and follow up with reports.

Table of Content

What ois Bypass Surgery?

Indication

What Procedure is followed :

Risk & Complication

More Info

Play video
Cardiac Problems
Hi, I am Ashok K Gupta. I am a Cardiac surgeon. I would like to tell you all about Cardiac problem.

By 2020, the cardiac problem has become a big hazard for our country. This is associated with Diabetes, blood pressure, smoking, over weight, lack of exercise etc. So, we have to take care of this and avoid such harmful things.

Prevention is better than Cure!

So, it will be better if we are stopping the problem so that you will noe end up with the disease.

ONce we have the problem, we have to go for proper investigation. We have to consult a doctor and proper investigation has to be done like ECG, TMT, CtNgo, Cholangiography. The modality of the treatment is going to be decided after the Angiography, that is the gold standard. Doodh ka doodh aur paani ka paani keval Angiography se he hota hai.

So, after getting this, if you have single block, discrete block, tube block, the treatment modality is Angioplasty.

And if you have multiple block, long block in many vessels and it is associated with the diabetes then we should go for the Bypass Surgery.

Thank you very much.
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