Heart bypass surgery is an action to overcome the blockage or narrowing of coronary arteries. This procedure is performed for patients with coronary heart disease, by utilizing blood vessels from other body organs as a shortcut to drain blood to the heart muscle.
The heart is a vital organ that pumps blood throughout the body, including the heart muscle itself. The blood supply to the heart muscle is supplied by coronary arteries which are divided into 2 branches, right and left. However, coronary arteries can become blocked or narrowed due to the process of atherosclerosis. Blocked heart arteries can cause heart attacks and heart failure. Heart bypass surgery aims to restore the supply of oxygen-rich blood to the heart muscle that was previously blocked.
Indications for Heart Bypass Surgery
Heart bypass surgery can be recommended if the patient has coronary heart disease with the following conditions:
- More than 1 blood vessel is narrowed, so the left ventricle does not function normally. The left ventricle of the heart is the chamber of the heart that pumps blood throughout the body.
- The main left coronary artery (left main artery) in charge of supplying blood to the left ventricle is experiencing narrowing or heavy blockage.
- Has blocked arteries that cannot be treated with a ring.
- Suffers from severe chest pain.
Warning for Heart Bypass Surgery
- This procedure is not recommended for patients with coronary heart disease who do not have symptoms who are at low risk of having a heart attack.
- Postoperative complications are higher in the elderly, especially those aged over 85 years.
- In addition to the elderly, patients who have recently had a heart attack or stroke, disorders of blood clots, have received radiotherapy in the chest area or surgery in the chest area before, have a history of COPD, and are experiencing an infection or electrolyte disturbance, are also at higher risk of experiencing postoperative complications.
Before Heart Bypass Surgery
As part of the preparation for heart bypass surgery, the doctor will give instructions to the patient about a number of activities that should not be done, eating patterns and healthy food types, and medicines that must be consumed before the surgery takes place.
The patient will undergo a series of initial tests before surgery, in the form of chest X-rays, blood tests, electrocardiography, and cardiac catheterization.
Heart Bypass Surgery Procedure
Heart bypass surgery lasts 3-6 hours and the patient will be given general anesthesia or general anesthesia, so that the patient is unconscious during the procedure.
The doctor will check the heart rate, blood pressure, oxygen levels in the body, and the function of the patient's respiratory system. After that, the breathing tube will be installed in the respiratory tract through the throat. This tube will be connected to a ventilator or breathing apparatus to provide the oxygen intake that the patient needs.
The heart surgeon (Sp. BTKV) will make an incision along the middle of the chest cavity and split the breastbone, until the heart is visible. Patients will be given drugs to stop the heart's work. After the heart stops, large blood vessels will be connected to the heart lung machine (heart lung machine) to replace the heart's work to maintain blood supply throughout the body.
Next, the doctor will graft a blood vessel from another part of the body, usually taken from a vein in the thigh or an artery around the chest cavity, which is attached from a large artery (aorta) to a coronary artery, which has passed through the area narrowed blood vessels, so that a new shortcut is formed that does not pass through a blocked coronary artery.
After the newly completed blood vessel transplant, the doctor will make the heart beat again. Sometimes, electric shocks are used to make the heart beat again. Then the doctor will reunite the sternum with a special wire that will permanently stick to the sternum, and close the incision in the skin with stitches. Previously installed breathing tube has not been removed so that the patient can breathe normally normally.
In addition to the techniques mentioned above, or so-called conventional techniques. There are also non-conventional techniques, including without stopping the heart rate, or using the help of a robot that allows surgery without splitting the breastbone.
After Heart Bypass Surgery
Because the breathing tube has not been removed, the patient will be placed in an intensive care unit (ICU), until the patient can breathe normally and the breathing tube can be removed. Usually 1-2 days treatment at the ICU. While in the ICU, doctors and nurses will monitor vital signs, namely heart rate, blood pressure, breathing, and temperature on a regular basis.
The recovery period after surgery can be short or long, depending on the patient's health condition. Patients will be allowed to go home even though they have not fully recovered, because it takes at least 6 weeks to 3 months to fully recover and carry out normal activities. During the recovery period, patients are advised to avoid strenuous activities.
Complications of Heart Bypass Surgery
With a good pre-operative assessment, as well as a growing surgical technique today, heart bypass surgery has a low risk of complications. However, open heart surgery can still cause complications, such as:
- Bleeding or wound infection.
- Arrhythmia or heart rhythm disorders.
- Blood clotting.
- Heart attack.
- Stroke.
- Chest pain.
- Kidney failure.
- Anesthetic allergic reaction.
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