Why Do I Need Heart Bypass Surgery
Bypass surgery treats symptoms of coronary artery disease. That happens when a waxy substance called plaque builds up inside the arteries in your heart and blocks blood and oxygen from reaching it.
Your doctor may suggest heart bypass surgery if:
- You have severe chest pain that your doctor thinks happens because several of the arteries that supply blood to your heart are blocked.
- At least one of your coronary arteries has disease that’s causing your left ventricle — the chamber that does most of your heart’s blood pumping — to not work as well as it should.
- There’s a blockage in your left main coronary artery, which gives your left ventricle most of its blood.
- You’ve had other procedures, and either they haven’t worked or your artery is narrow again.
- You have new blockages.
What Happens Before Heart Surgery
Preparation for your surgery can take weeks or months. Before your heart surgery is scheduled, your medical care team will evaluate your condition. Your care team will likely include your primary care doctor and cardiologist. Youll also consult with a cardiothoracic surgeon .
Your care team will give you a medical evaluation. This includes:
- Talking about your symptoms and how long theyve been going on.
- Talking about your medical history and your biological familys medical history.
- Blood tests to check your cholesterol and other important numbers.
Your team will also run some diagnostic tests. These tests provide a detailed picture of your heart function and any problems. They also help you and your care team decide if you need surgery and what type you need.
If you need surgery, your care team will tell you exactly how to prepare and what to expect. Its important to follow their recommendations about:
- When to stop taking any medications.
- When to begin fasting the day before your surgery.
- Quitting smoking or tobacco use and reducing alcohol consumption to lower your risk of complications.
Be sure to ask any questions you have, even if they seem small or you think you asked them already. Its better to double-check to make sure youre as prepared as possible for your surgery.
What to expect after youre admitted to the hospital
- Tests like an EKG or chest X-ray.
- Hair shaved from the spot where youll have your incision.
- Blood tests.
Are There Alternatives To Standard Open
Thanks to medical advancements, many procedures that once required opening the chest can now take place using minimally invasive heart surgery or with small incisions. The surgeon sometimes still needs to cut through part of the breastbone .
Depending on your situation, your surgeon may be able to use these methods:
- Catheter-based: Your surgeon threads a catheter to the heart. The surgeon then inserts surgical instruments, balloons, or stents through the catheter to perform a procedure. Catheter-based procedures include transcatheter aortic valve replacement and coronary angioplasty and stenting.
- Video-assisted thoracic surgery : Your surgeon performs VATS by inserting a tiny video camera and surgical instruments into several small chest incisions. Your surgeon may use VATS to place a pacemaker, repair heart valves or treat an arrhythmia.
- Robotically-assisted: Certain patients with valvular heart disease, cardiac tumors, atrial fibrillation and septal defects may be candidates for this minimally invasive approach.
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What Happens During Robotic Cardiac Surgery
The following is the general sequence of events that will most likely occur during robotic cardiac surgery:
- You may receive a sedative before the procedure to help you relax.
- You will be placed under general anesthesia for the procedure and you will have a breathing tube.
- A surgeon will make a series of keyhole-sized incisions on the side of your chest. These incisions will align with the openings between your ribs.
- You may need to be placed on the heart-lung machine for the procedure.
- Depending on the procedure being done, your surgeon will insert several precision-guided robotic arms into these incisions.
- These robotic arms hold and manipulate tiny instruments to do the required tasks on the heart or surrounding arteries.
- A tiny video camera will be inserted into another incision to provide a magnified, three-dimensional image of the operating site.
- The surgeon will control the robotic arms and camera from a console located within the operating room.
- Once complete, the surgeon will remove the instruments and close the incisions.
Talk with your healthcare provider about what you will experience during your procedure.
Who Is In Theater For Open Heart Surgery
A team of doctors and other health professionals work together in the operating theater during open heart surgery.
The team is likely to include:
- the lead surgeon who will direct others surgeons who will assist during the operation
- the anesthesiologist, who is in charge of giving and anesthesia and monitoring vital signs
- the pump team, also known as perfusionists, operate the heart-lung machine and other technical equipment that supports open heart surgery
- nurses and technicians, who assist the surgical team and prepare the operating theater for surgery
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Open Heart Surgery What To Expect As A Patient
Diagnosis Most patients will see a cardiologist first who will diagnose their problem based on their story, physical exam, and tests. Multiple tests may be required including echocardiograms, CT scans, and a heart catheterization. Once the diagnosis and the need for open heart surgery have been determined then the patient is referred to a cardiac surgeon for an evaluation.
Meeting the Surgeon Surgeons will often be suggested by the cardiologist depending on their referral patterns however often patients will select their own surgeons based on other recommendations or their own research. Once this is decided the patient will go and meet the surgeon in clinic. Here the surgeon will talk with the patient and review the testing. Based on this meeting a surgical recommendation can be made and operative risk and suitability can be determined. In many cases the surgeon may ask for further testing to be performed.
Details of the Operation
Making the Incision In the case of classic open heart surgery, the breast bone will be split open using a saw. Alternative approaches may use incisions to the side of the bone between the ribs or through some of the ribs on the side. In robotic heart approaches, no large incisions are made, and small tubes are inserted through which the operation is performed, sometimes called keyhole surgery.
The heart lung bypass machine.
The Operation Itself
open heart surgery beating heart with a bypass
open heart surgery sternal wiring
Who Can Have Minimally Invasive Heart Surgery
Most minimally invasive cardiac surgeries are best for patients who have valvular heart disease including aortic, mitral, and tricuspid valve stenosis or regurgitation . In addition, minimally invasive cardiac surgery can be used to treat atrial fibrillation. It can also be used to close atrial septal defects and patent foramen ovales.
Some patients who need coronary artery bypass surgery may also be able to have MICS.
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What Happens During Heart Surgery
What happens during your surgery depends on the type youre having. It also depends on the method your surgeon uses to perform the operation.
Surgeons use different methods for operating on your heart. These include open-heart surgery, off-pump bypass surgery and minimally invasive heart surgery. Your care team will discuss which method is best for you, and why.
Open-heart surgery is what most people think of when they hear someone say heart surgery. Your surgeon makes a 6-to 8-inch long incision in the middle of your chest and spreads your ribcage to reach your heart. Youll be connected to a heart-lung bypass machine, so your heart wont be beating during the surgery.
The length of traditional open-heart surgery varies based on whats being fixed. CABG surgery takes about three to six hours.
Off-pump bypass surgery
Off-pump bypass surgery is also called beating heart surgery. Its similar to traditional open-heart surgery, but you wont be on a heart-lung bypass machine. This method can only be used for CABG surgery. And its most suitable when only one or two coronary arteries need to be bypassed.
Minimally invasive surgery
Minimally invasive heart surgery is also called a keyhole surgery. This means your surgeon makes smaller incisions to access your heart.
A partial sternotomy involves a 3- to 4-inch incision through part of your sternum . A mini-thoracotomy avoids your breastbone and instead uses small cuts between your ribs.
What To Eat And Avoid After Heart Surgery
Heart disease is one of the leading causes of death worldwide. The incidence of heart disease has increased in the recent years due to lifestyle changes, increased stress, food habits, etc. Due to the advancements in medical technology heart surgery has become very common these days and the success rates associated with them are also very high. There are different types of heart surgeries such as bypass surgery, heart transplant, cardiomyoplasty, artificial heart valve surgery, etc. Generally your cardiologist will recommend a special diet after your heart surgery to help your heart heal and recover and for long term maintenance of your health.
Coronary Artery Bypass Grafting
Coronary artery bypass grafting, also called revascularization, is a common surgical procedure to create an alternative path to deliver blood supply to the heart and body, with the goal of preventing clot formation. This can be done in many ways, and the arteries used can be taken from several areas of the body. Arteries are typically harvested from the chest, arm, or wrist and then attached to a portion of the coronary artery, relieving pressure and limiting clotting factors in that area of the heart.
The procedure is typically performed because of coronary artery disease , in which a plaque-like substance builds up in the coronary artery, the main pathway carrying oxygen-rich blood to the heart. This can cause a blockage and/or a rupture, which can lead to a heart attack.
How Long Can You Live After Heart Surgery
You can live for many years or decades after heart surgery. Many factors affect how long you live, including other health conditions and risk factors. Heart surgery can make you healthier and stronger. But its important to keep doing whatever you can to lower your risks for future problems. Things you can do include:
- Make lifestyle changes recommended by your healthcare provider.
- Take your medications as prescribed.
- Keep all your medical appointments and follow-ups.
Heart surgery is like a bicycle that can carry you down a long road when youre tired of walking, but you still have to push the pedals.
Who Needs To Have Heart Surgery
People with many different heart problems need heart surgery. These include blockages in the arteries that carry blood to your heart, valves that arent working right, and abnormal heart rhythms.
Usually, heart surgery is planned in advance as part of your treatment plan. This happens when your provider diagnoses a problem with your heart, and surgery is the best or only way to fix it.
Other times, heart surgery is an emergency treatment that comes up when you dont expect it. This can happen if you have a heart attack, or if youre diagnosed with severe blockages that put you in urgent danger.
Depending on the problem, you may not need surgery. Technology is providing us with innovative ways to manage heart disease. For example, percutaneous coronary intervention repairs blocked coronary arteries. Endovascular aneurysm repair repairs an abdominal aortic aneurysm through an artery in your leg.
These methods reduce your time in the hospital and make recovery easier. Theyre especially helpful for people who would face higher risks if they had surgery.
What Happens After Heart Surgery
After your heart surgery is done, youll be moved to the intensive care unit . Youll recover in the ICU for at least one day. Youll then move to a regular hospital room for continued rest and care.
How long you stay in the hospital depends on the surgery you had and how your body responds to it. Each persons recovery is different. Your hospital team will keep a close eye on you and make sure youre healing as you should. Theyre also prepared to notice and respond to any problems that come up.
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What Approaches Do Surgeons Use To Do Heart Surgery
The approach a surgeon uses to do heart surgery depends on your heart problem, your general health, and other factors. Approaches to heart surgery include:
- Open-heart surgery is when the surgeon cuts the chest open to reach the heart. Because it’s difficult to operate on a beating heart, medicines are used to stop the heart. A heart-lung bypass machine keeps oxygen-rich blood pumping through the body during the surgery.
- Off-pump heart surgery is open-heart surgery on a beating heart without using a heart-lung bypass machine. The surgeon holds the heart steady with a device. Surgeons may use off-pump heart surgery to do coronary artery bypass grafts , but only in certain cases.
- Minimally invasive heart surgery uses small cuts between the ribs. The cuts may be as small as 2 to 3 inches. The surgeon inserts tools into the chest through the cuts. This type of heart surgery may or may not use a heart-lung bypass machine.
- Robotic-assisted surgery is a type of minimally invasive surgery. The surgeon uses a computer to control tools on the arms of a robot. This allows the surgeon to be very accurate when doing difficult operations.
Diet After Heart Surgery: Dos And Don’ts
Foods you should eat after heart surgery
1. Whole grains
Whole grains include whole wheat, oats/oatmeal, rye, barley, corn, brown rice, wild rice and millet. They are a rich source of dietary fibers. Dietary fibers reduce the levels of bad cholesterol, help prevent the occurrence of diabetes and stroke and improve heart health. The insoluble dietary fibers present in whole grains have been reported to increase heart health by slowing the progression of cardiovascular diseases.
Whole grains also contain B vitamins, magnesium, selenium and iron. Moreover, eating whole grains satiate your hunger easily, helping you maintain a healthy weight. They also help prevent constipation. The American Heart Association recommends that you should consume 25 gm of whole grains for a 2000 calorie diet.
2. Heart healthy vegetables
Vegetables should form an integral part of your diet after heart surgery. Some of the heart healthy vegetables are:
3. Heart healthy fruits
Foods that you can include in your diet after heart surgery are:
4. Heart healthy fish
Fish, which are rich in omega-3 fatty acids, are good for the heart. Omega-3 fatty acids are unsaturated fat and when substituted for saturated fat in the diet help lower your cholesterol levels and keep your heart healthy. Omega 3 fatty acids reduce inflammation in the body and prevent damage to the blood vessels, thereby, preventing heart disease and stroke.
Omega 3 fatty acids are also known to:
5. Eat more lean protein
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What Is A Heart Surgery
Heart surgery is the most common of cardiovascular surgical procedures. This article gives a general overview of what heart surgery involves and how it is performed.
Before the heart surgery, the patient would be put under general anesthesia. The surgeon would then make an incision to view and operate on the patients heart. There are different types of heart surgeries: open-heart, closed-heart, and hybrid procedures.
Heart Surgery Types:
Open-Heart Surgery: An operation where part of your chest or your ribcage is opened up so that your surgeon can see and operate on your heart without making any incisions on it .
Closed-Heart Surgery: An operation where you have some heart problems, and the doctor makes a cut in your heart to fix it. In most cases, this operation is done with open-heart surgery, which has a better success rate.
Minimally Invasive Heart Surgery
and Minimally Invasive Coronary Artery Bypass Graft
What the Procedure Does
An alternative to standard bypass surgery . Small incisions are made in the chest. Chest arteries or veins from your leg are attached to the heart to “bypass” the clogged coronary artery or arteries. The instruments are passed through the ports to perform the bypasses. The surgeon views these operations on video monitors rather than directly. In PACAB, the heart is stopped and blood is pumped through an oxygenator or “heart-lung” machine. MIDCAB is used to avoid the heart-lung machine. It’s done while the heart is still beating. Requires several days in the hospital.
Reason for the Procedure
- Manages blockage of blood flow to the heart and improves the supply of blood and oxygen to the heart.
- Reduces risk of heart attack.
- Improves ability for physical activity.
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Q How Do I Care For Someone Who Has Undergone Heart Surgery
If I Need Heart Surgery What Are My Next Steps
If you think or have been told you need heart surgery, your next step should be to get an evaluation or second opinion from a cardiac surgeon. Our surgeons can help you decide if surgery is truly necessary, and if so, which type of approach makes the most sense for you and your particular condition.
To get started, call 305-2633 or use ourappointment request form.
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