The
phrase "bypass surgery" usually refers to an operation also
called coronary artery bypass grafting (CABG, often referred to as
"cabbage"). This surgery corrects badly blocked heart arteries
to prevent someone from having a heart attack. CABG may have to be
done as an emergency for people with severe symptoms.
The heart arteries may become clogged with cholesterol, or develop
atherosclerosis, for many reasons. Genetics and aging play a role,
as do smoking, high blood pressure, diabetes, high cholesterol, and
other factors. When the effects of this blockage become severe, the
blood flow to a portion of the heart can decrease or stopped suddenly.
This can result in chest pain, difficulty in breathing, and heart
attacks.
If
medications fail, bypass surgery may be needed in the treatment of
blocked heart arteries. Cardiac imaging is often done before surgery
because the results help doctors choose the best treatment. The surgeon
will discuss the alternatives and answer any questions before the
CABG operation.
The surgery is done in an operating room and requires general anesthesia.
This means that a person is put completely to sleep with medications
and will not be able to move. An artificial breathing machine is required
to give the person oxygen while he or she is asleep. During this type
of anesthesia, a person feels no pain. Once the person is asleep,
the skin on the chest is cleaned with special soap to reduce the risk
of infections.
A cut is made into the chest, often in the breastbone, to expose the
heart. During the surgery, a person will be hooked up to a special
device called a heart-lung machine. This device keeps the blood circulating
and full of oxygen while the surgeon operates. CABG involves removing
a blood vessel from another part of the person's body. A small blood
vessel is generally removed from a person's chest or leg. This blood
vessel is used to form a bypass, or detour, around the area or areas
of heart artery blockage. Blood can flow through the bypass to reach
the heart. When three areas of blockage need to be bypassed, a person
is said to have had a "triple" bypass.
Once the new blood vessels are sewn in place, the person is taken
off the heart-lung machine and the chest incision is closed. When
the surgery is completed, the person is taken to the recovery room.
In this area, the person can be watched closely while the anesthesia
wears off. Pain medication is given as needed. Once a person is breathing
well on his or her own, the artificial breathing machine is turned
off.
After CABG, a person will need to stay at least a few days in the
hospital. Full recovery can take months, though many can leave the
hospital in less than a week. CABG, like any serious surgery, carries
risks. Reactions to any medicines used, infections, bleeding and even
death can occur. However, many people advised to get CABG surgery
will die if they don't have the operation.
Home instructions and a follow-up appointment with the surgeon are
generally given before a person leaves the hospital. If the recovery
goes well, a person with an "office" job can usually return
to work within a month or two. This time period can be longer for
those with more physically demanding jobs - some may even have to
change careers.
After surgery and recovery, further treatment is the key to prevent
future problems. Medications are needed to treat high blood pressure,
diabetes, or high cholesterol if present. Other "heart"
medications may also be given. Those who smoke are advised to quit.
Eating a proper diet and exercising are also important to maintain
health. Regular doctor visits, medication adjustments, and blood tests
are commonly used to help follow a person's condition after recovery.
CABG surgery has saved many lives and improved the health of many
people with heart artery blockage. However, bypass surgery is a major
operation with serious risks. For this and other reasons, prevention
is still the best treatment for heart disease.
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