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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

Multivessel Stenting Or Bypass Surgery - Understanding The Difference!

Multi-Speciality Clinic
Cardiologist, Hyderabad
Multivessel Stenting Or Bypass Surgery - Understanding The Difference!

The results of a study conducted by the Department of Medicine, University of Ulsan, Korea, show that multivessel coronary stenting can be performed with a high success rate along with an acceptable clinical outcome. Coronary stenting has proven itself to be an accepted means for treating of obstructed coronary arteries. The need for multivessel coronary stenting has been inflated because of the larger number of patients with unfavourable cardiac profiles. Conventionally, bypass surgery is regarded as a standard means for relieving angina in cardiac patients with multivessel coronary disease as it could lead to a downright revascularization. Further, it also allows a prolongation of lifespan in a specified subgroup of patients.

How are they performed: Despite the coming of modern generation of stents, patients with multiple stringent arteries in the heart receiving coronary after bypass have recovered better than those whose arteries were grafted with balloon angioplasty or stenting. This report is presented in the 64th Annual Scientific Session in the American College of Cardiology. This report echoes past studies which shows that patients afflicted with multiple narrowed arteries receive better results with coronary artery bypass grafting, which is also known as CABG or bypass heart surgery. In case of multivessel stenting, which is known as angioplasty or percutaneous coronary intervention or PCI, a stent is put within the arteries to hold it wide open and facilitate the flow of blood.

Which one is better: In a new study, it is reported that patients with new stents are susceptible to 47% higher risk of any of the outcomes like death or cardiac arrest as compared to patients who undergo bypass surgery. In CABG, a vein or artery from other parts of the body is grafted on the constricted coronary artery for allowing easy blood flow to and from heart. This study reinforces present regulations that recommend CABG to treat patients with substantial constrictions in various arteries, a condition often termed as multivessel coronary artery ailment.

Renowned cardiologist Seung Jung Park from Asan Medical Centre in Seoul, South Korea opines that CABG is still a much preferred option on the basis of their medical data. Another study known as Bypass Surgery Versus Everolimus - Eluting Stent Implantation for Multivessel Coronary Artery Disease or BEST trial deserves mention. It is one of the two randomly controlled trials for comparing bypass to angioplasty since the introduction of modernised stents that emits medication, which would prevent blood clot.

This study was implemented on 880 patients at 27 healthcare centres in four countries. Each patient had multivessel coronary artery disease and were determined to be equally eligible to go through either of the methods. Half of these patients were randomly chosen to be given angioplasty with everolimus-eluting stents, and the other half received bypass surgery.

All the patients were tracked for about five years and during this prolonged follow up, angioplasty was related to a considerable upsurge in the incidence of myocardial infarction, target vessel revascularization and often death. Because, it is a more invasive process, bypass surgery is normally recommended only for patients afflicted with higher-risk constrictions in more than one artery.

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

3752 people found this helpful

How To Recover After Heart Surgery?

MBBS, DNB (General Surgery)
General Surgeon, Chennai
How To Recover After Heart Surgery?

Once the heart surgery is complete, the initial recovery process from the wounds and incisions can take almost two months. The doctor will give you instructions on how to take care of yourself post-surgery so you recuperate faster and be back in the pink of health.

Road to recovery

  1. The first step is to take care of the wounds; make sure that you keep the area of the incision dry. Avoid taking baths for the first few days. If you notice any sign of infection such as redness around the area, pus oozing out or high fever, then do not waste time consult a doctor. Experiencing symptoms such as the breastbone shifting and cracking when you move should not be disregarded at all.
  2. Post-surgical pain is another area that you need to address. The area adjoining the incision can be painful till the first few weeks pass and there may be pain and stiffness in the surrounding muscles as well. In case of a bypass surgery, the legs may hurt if the veins from the legs were used as grafts. The pain and the soreness will recede with time.
  3. Avoid heavy activity for the first two months post-surgery. Start with small tasks, and gradually build up your activity levels so that the body gets used to it. Avoid activities such as standing for 15 minutes or more at the same place and lifting heavy things. Make sure to consult your physiotherapist before you start with light exercises such as walking.
  4. The recovery process also depends on the type of food you eat; because eating healthy food can certainly rev up the recovery process. Initially, you may not feel like eating much, so get your appetite up in a gradual manner. It is best to avoid any junk meal at this point in time as that can adversely affect your body’s metabolism even further. It is important that you get the required amount of rest so that your body can recuperate. In case you have a concern or query you can always consult an expert & get answers to your questions!
2919 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

Bariatric Surgery - A Boon For Patients Suffering From Diabetes!

MS - General Surgery, MBBS
General Surgeon, Delhi
Bariatric Surgery - A Boon For Patients Suffering From Diabetes!

Diabetes is a gnawing problem that affects millions throughout the world. It is a disorder that if overlooked can lead to serious diseases; cardiovascular ailments, problems related to vision, kidney problems and many more. While medication tries to regulate your blood sugar levels, it is not always unfailing. Medication along with changes in your diet and lifestyle can still not improve your condition in certain cases. At times it is hard to increase the insulin production in a person's body even after administering medicines solely known for their efficacy. Such kind of diabetic patients can therefore benefit from a Bariatric surgery.

What is a Bariatric surgery?

Bariatric surgery doesn't refer to a single operative method. It involves a host of surgical procedures conducted on a person to rid him or her of obesity. Obesity in combination with diabetes can make a person's life miserable. The treatment of one can come in the way of curing the other. A diabetic patient who also suffers from obesity usually finds it hard to lose weight in spite of exercising or being on diet. Surgery comes to their rescue. This kind of surgery should be fallen back upon as the lender of last resort that is to say when other solutions have not helped. Bariatric surgery is always performed under skilled supervision. It might include reduction of the size of your stomach, removal of a portion of the stomach, or even gastric bypass surgery.

How does Bariatric surgery help reduce Diabetes?

Diabetes can be of three basic kinds;

Type 1 diabetes in which the body produces no amount of insulin.

Type 2 diabetes in which the body produces an insufficient amount of insulin or Gestational diabetes that pregnant women tend to contract.

Bariatric surgery proves to be very advantageous for patients of Type 2 diabetes:

1. Surgery lowers blood sugar levels considerably. Research shows people with acute diabetes made huge improvements after having undergone a Bariatric surgery. Their blood sugar levels dropped by a noticeable percentage and they felt healthier. Reduced blood sugar is an almost immediate effect in some while for others it does take some time.

2. Bariatric surgery exercises a control over cholesterol, blood pressure and triglyceride levels.

3. The impressive benefits of this operation for a Type 2 diabetes patient are not superficial or temporary. If the patient adheres to the lifestyle prescribed by a doctor, takes medication regularly and follows the basics of post- operative care he or she is likely to remain beyond the ambit of this metabolic disorder.

4. It successfully takes care of ailments resulting from diabetes.

5. Bariatric surgery can eliminate the need for medication or it can reduce the dosage of medicines you take.   

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

              

Type diabetes

2684 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!

2449 people found this helpful

Popular Questions & Answers

Open heart bypass surgery undergone. After four months of surgery I'am feeling uneasiness on back and shoulders unable to walk few steps. Kindly advice.

C.S.C, D.C.H, M.B.B.S
General Physician, Alappuzha
There is no specific reason for uneasiness after bypass and you have to see your doctor for a review.

I had undergone Bypass surgery (CABG 3 Grafts) in 2011 @age of 44. Regularly taking cardivas CR 20, cilnidipine 10 mg, ecosprin 75 mg with clopidogrel 75 mg, rosuvastatin 20 mg and telmisartan 40 mg. Is it ok?

MBBS
General Physician, Mumbai
As of now it seems to be okay and medication needs to be taken for a pretty long time and once a year get your heart status checked with your cardiologist.

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

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.

MBBS
General Physician, Fatehabad
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.

Table of Content

What ois Bypass Surgery?

Indication

What Procedure is followed :

Risk & Complication

More Info

Having issues? Consult a doctor for medical advice