20 years after aksh. Surgery, or bypass. Nutrition and water balance rules

Heart disease a large number of, and each of them is dangerous for humans in its own way. But the most common and rather difficult to treat is vascular occlusion, when cholesterol plaques block the path of blood flow. In this case, a person is prescribed a special operation - bypass surgery of the heart vessels.

What is shunting?

First of all, you need to understand what is vascular bypass surgery, which is often the only way restore their vitality.

The disease is associated with poor blood flow through the vessels leading to the heart. Circulatory disorders can be in one or several coronary arteries. It is precisely this indication that implies such an operation as coronary artery bypass grafting.

After all, if even one vessel is blocked, it means that our heart does not receive the right amount blood, and with it the nutrients and oxygen that saturate the heart, and from it - and our entire body with everything necessary for life. The lack of all these components can lead not only to a serious disease of the cardiac system, but in some cases even leads to death.

Surgery or bypass

If a person has already begun to malfunction in the work of the heart and there are signs that the blood vessels are clogged, the doctor may prescribe medication. But if it is revealed that the drug treatment did not help, then in this case an operation is prescribed - bypassing the heart vessels. The operation is carried out in the following sequence:

This workaround is called a shunt. For proper blood flow in the human body, a new path is being created that will function at full strength. Such an operation lasts about 4 hours, after which the patient is placed in the intensive care unit, where he is monitored by medical staff around the clock.

Positive aspects of the operation

Why a person who has all the prerequisites for bypass surgery must definitely go for an operation, and what exactly can coronary artery bypass surgery give him:

• Completely restores blood flow in the area of ​​the coronary vessels, where there was a weak patency.
• After surgery, the patient returns to his usual way of life, but there are still some limitations.
• Significantly reduces the risk of myocardial infarction.
• Angina pectoris fades into the background, and attacks are no longer observed.

The technique of conducting the operation has been studied for a long time and is considered very effective, allowing to prolong the life of the patient for many years, so the patient should decide to bypass the heart vessels. Patient reviews are only positive, most of them are satisfied with the outcome of the operation and their further condition.

But, like every surgical intervention, this procedure also has its drawbacks.

Possible Complications of Bypass Surgery

Any surgical intervention is already a risk for a person, and intervention in the work of the heart is a special conversation. What are the possible complications after heart bypass surgery?

1. Bleeding.
2. Thrombosis of deep venous vessels.
3. Atrial fibrillation.
4. Myocardial infarction.
5. Stroke and various kinds of circulatory disorders in the brain.
6. Infections of the operating wound.
7. Shunt narrowing.
8. After the operation, there may be divergence of the seams.
9. Chronic pain in the area of ​​the wound.
10. Keloid postoperative scar.

It seems that the operation was carried out successfully and there are no disturbing notes. Why can complications occur? Could this have something to do with the symptoms the person had before the bypass was performed? Complications are possible if, shortly before the operation, the patient had:

• acute coronary syndrome;
• unstable hemodynamics;
• severe type of angina pectoris;
• atherosclerosis of the carotid arteries.

In order to prevent all possible complications, the patient undergoes a series of examinations and procedures before the operation.

However, it is possible to perform an operation using not only a blood vessel from the human body, but also a special metal stent.

Contraindications for stenting

The main advantage of stenting is that this procedure has almost no contraindications. The only exception is the refusal of the patient himself.

But there are still some contraindications, and doctors take into account the severity of the pathologies and take all precautions so that their impact on the course of the operation is minimal. Cardiac stenting or bypass surgery is contraindicated in people with kidney or respiratory failure, with diseases that affect blood clotting, with allergic reactions for preparations containing iodine.

In each of the above cases, the patient is preliminarily treated with therapy, its goal is to minimize the development of complications. chronic diseases sick.

How is the stenting procedure performed?

After the patient has been given an anesthetic injection, a puncture is made on their arm or leg. It is necessary so that through it it is possible to introduce a plastic tube into the body - an introducer. It is necessary so that later through it all the necessary tools for stenting can be inserted.

A long catheter is inserted through a plastic tube to the damaged part of the vessel, it is installed in the coronary artery. After that, a stent is inserted through it, but with a deflated balloon.

Under pressure contrast agent the balloon inflates and expands the vessel. The stent is left in the person's coronary vessel for life. The duration of such an operation depends on the extent to which the patient's vessels are affected, and can be up to 4 hours.

The operation is performed using x-ray equipment, which allows you to accurately determine the place where the stent should be located.

Types of stents

The usual form of a stent is a thin metal tube that is inserted into the vessel, it has the ability to grow into the tissue after a certain period of time. Taking into account this feature, a species with a special drug coating was created, which increases the operational life of the artificial vessel. It also increases the likelihood of a positive prognosis for the patient's life.

First days after surgery

After the patient underwent bypass surgery of the heart vessels, the first days he is under the close attention of doctors. After the operation, he is sent to the intensive care unit, where the restoration of the work of the heart takes place. It is very important during this period that the patient's breathing is correct. Before the operation, he is taught how he will have to breathe after the operation. Even in the hospital, the first rehabilitation measures are being carried out, which should be continued in the future, but already in the rehabilitation center.

Most patients after such a rather complicated heart surgery again return to the life they led before it.

Rehabilitation after surgery

As after any type of operation, the patient can not do without the recovery phase. Rehabilitation after heart bypass surgery lasts for 14 days. But this does not mean that a person who has undergone such a complex procedure can continue to lead the same lifestyle as before the illness.

He needs to reevaluate his life. The patient must completely remove drinks containing alcohol from his diet and quit smoking, since it is these habits that can become provocateurs for a further rapid turn of the disease. Remember, no one will give you a guarantee that the next operation will be completed successfully. This call indicates that the time has come to lead a healthy lifestyle.

One of the main factors to avoid recurrence is the diet after heart bypass surgery.

Diet and nutrition after surgery

After a person who has undergone bypass surgery returns home, he wants to eat his usual food, and not diet cereals given to him in the hospital. But a person can no longer eat as it was before the operation. He needs special food. After bypassing the vessels of the heart, the menu will have to be revised, it must be sure to minimize the amount of fat in it.

You should not eat fried fish and meat, take margarine and butter in small doses and preferably not every day, and remove ghee from the diet altogether, replacing it with olive oil. But don't worry, you can eat unlimited amounts of red meat, poultry, and turkey. Doctors do not recommend eating lard and pieces of meat with layers of fat.

In the diet of a person who has undergone such a serious operation as heart bypass surgery, after the operation, there should be a lot of fruits and vegetables. Very well reflected in the health of your heart 200 grams of freshly squeezed orange juice daily in the morning. Nuts - walnuts and almonds - should be present in the diet every day. Blackberries are very useful, as they are saturated large quantity antioxidants, and they help lower blood cholesterol levels.

Fatty dairy products should also be avoided. It is better to take dietary bread, in which neither butter nor margarine is present.

Try to limit yourself in carbonated drinks, drink more purified water, you can drink coffee and tea, but without sugar.

Life after surgery

None of the methods of treating heart diseases and dilating blood vessels can be considered ideal, which would relieve the disease for life. The problem is that after the expansion of the walls of the vessel in one place, no one can guarantee that after a while atherosclerotic plaques will not block another vessel. Atherosclerosis is a disease that continues to progress, and it will not be completely cured of it.

Within a few days after the operation, the patient spends 2-3 days in the hospital, and then he is discharged. Further life after bypass of the patient's heart vessels depends only on him, he must follow all the doctor's prescriptions, which concern not only nutrition, exercise, but also supporting drugs.

Only the attending doctor can give a list of medicines, and each patient has his own, because they take into account accompanying illnesses. There is one medicine that is prescribed to all patients who have undergone bypass surgery - this is the drug "Clopidogrel". It helps to thin the blood and prevents the formation of new plaques.

Take it for a long time, sometimes up to two years, it helps slow the progression of atherosclerosis in the blood vessels. The effect will be only if the patient completely restricts himself in taking fatty foods, alcohol and smoking.

Stenting or shunting is a sparing operation that allows you to restore the patency of blood through the vessels of the heart for a long time, but the positive effect of it depends only on the patient himself. A person should be as careful as possible, follow all the recommendations of the attending doctor, and only in this case he will be able to return to work and not feel any inconvenience.

Bypass surgery should not be feared, because after it all your symptoms will disappear, and you will again begin to breathe deeply. If you are recommended an operation, then you should agree, because no other treatment for thrombosis and atherosclerotic plaques in the vessels has yet been invented.

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In February of this year, I came across an article titled “Shunts Are Not Forever”. The correspondent of the newspaper "Vechernyaya Moskva" talked with the head of the laboratory of X-ray and vascular methods of the Cardiology Research Center, Doctor of Medical Sciences A.N. Samko. It was about the effectiveness of coronary artery bypass grafting (CABG). Dr. Samko painted a bleak picture: after a year, 20% of shunts are closed, and after 10 years, as a rule, everything! Repeat shunting, in his opinion, is risky and extremely difficult. And this means that life is guaranteed to be extended by only 10 years.

My experience as a long-term cardiac surgical patient who has undergone two coronary artery bypass surgery suggests that these periods can be increased - primarily through regular physical activity.

I see my illness and operations as a challenge of fate, which must be actively and courageously resisted. Unfortunately, physical activity after CABG is mentioned only in passing, by the way. Moreover, there is an opinion that some patients after heart surgery live happily and for a long time without any effort. I have not met such people. What I want to talk about is not a miracle, not luck and not a lucky coincidence, but a combination of the high professionalism of the doctors of the Russian Scientific Center for Surgery and my perseverance in fulfilling my own program of restrictions and loads (RON).

My story is this. Born in 1935. In his youth, he suffered from malaria for many years, during the war he suffered from typhus. Mother - heart, died at 64 years old.

In October 1993, I suffered an extensive transmural posterior-lateral myocardial infarction of the left ventricle, and in March 1995 I underwent coronary artery bypass grafting - 4 shunts were sewn in. 13 years later, in April 2008, angioplasty of one shunt was performed. The other three functioned normally. And after 14 years and 3 months, I suddenly started having angina attacks, which I had never had before. I went to the hospital, then to the Scientific Cardiology Center. I underwent further examination at the Russian Scientific Center for Surgery. The results showed that only two of the four shunts functioned normally, and on September 15, 2009, Professor B.V. Shabalkin performed a second operation on me coronary artery bypass grafting.

As you can see, I have significantly extended my life expectancy with shunts, and I am convinced that I owe this to my RON program.

Doctors still consider my postoperative physical activity too high, they advise me to rest more and drink medicines constantly. I cannot agree with this. I want to make a reservation right away - there is a risk, but this risk is justified. Realizing the seriousness of my situation, from the very beginning I introduced certain restrictions into my system: I excluded jogging, exercises with dumbbells, on the crossbar, push-ups on my hands from the floor and other strength exercises.

Usually, doctors at polyclinics attribute CABG surgery to aggravating factors and believe that the operated person is destined for one lot: quietly, calmly live out his life and constantly drink medicines. But shunting ensures the normal blood supply to the heart and the body as a whole! And how much labor has been invested, effort and money expended to save the patient from death and give him the opportunity to live on!

I am convinced that even after such a difficult operation, life can be full. And I cannot put up with the categorical statements of some doctors that my loads are excessive. They are good for me. But I know that if atrial fibrillation appears, severe pain in the region of the heart, or the lower limit of blood pressure exceeds 110 mm Hg, you should immediately call an ambulance doctor. Unfortunately, no one is immune from this.

My RON program includes five items:

1. Physical training, constant and gradually increasing to a certain limit.

2. Restrictions in nutrition (mainly anti-cholesterol).

3. Gradual reduction of medication intake to the point of completely eliminating them (I only take them in emergency cases).

4. Prevention of stressful conditions.

5. Constant employment with an interesting business, leaving no free time.

Gaining experience, I gradually increased physical activity, included new exercises, but at the same time strictly controlled my condition: blood pressure, heart rate, did orthostatic test, heart fitness test.

My daily physical activity consisted of measured walking (3-3.5 hours at a pace of 138-140 steps per minute) and gymnastics (2.5 hours, 145 exercises, 5000 movements). This load (metered walking and gymnastics) was performed in two steps - in the morning and in the afternoon.

Seasonal activities were added to daily activities: skiing with stops every 2.5 km to measure heart rate (21 km in total in 2 hours 15 minutes at a speed of 9.5 km per hour) and swimming, one-time or fractional - 50- 200 m (800 m in 30 minutes).

In the 15 years that have passed since the first CABG operation, I have walked 80 thousand kilometers, covering a distance equal in length to two equators of the earth. And until June 2009, he did not know what angina attacks or shortness of breath were.

I did this not out of a desire to demonstrate my exclusivity, but out of the conviction that blood vessels, natural and artificial (shunts), fail (clog) not from physical exertion, especially strenuous ones, but because of progressive atherosclerosis. Physical activity, on the other hand, inhibits the development of atherosclerosis, improves lipid metabolism, increasing the content of high-density (good) cholesterol in the blood and reducing the content of low-density (bad) cholesterol - thereby reducing the risk of thrombosis. For me, this is very important, since my total cholesterol fluctuates at the upper limit. Only the fact that the ratio of high and low density cholesterol, the content of triglycerides and the cholesterol coefficient of atherogenicity never exceed the established norms helps out.

Physical exercises, gradually increasing and giving an aerobic effect, strengthen muscles, help maintain joint mobility, increase minute blood output, reduce body weight, have a beneficial effect on bowel function, improve sleep, increase tone and mood. In addition, they help in the prevention and treatment of other age-related diseases - prostatitis, hemorrhoids. A reliable indicator that the load is not excessive is nasal breathing, so I breathe only through the nose.

Everyone is sufficiently informed about dosed walking. But I still want to confirm its usefulness and effectiveness by citing the opinion of a well-known surgeon who himself was not involved in sports, but was fond of hunting. Hunting is a long walk. It will be about Academician A. V. Vishnevsky. From his student years, carried away by anatomy and having mastered the prosector's art to perfection, he liked to tell his acquaintances all sorts of amusing details. For example, that in each limb of a person there are 25 joints. With each step, therefore, 50 articulated sections are set in motion. 48 joints of the sternum and ribs and 46 bony surfaces of the spinal column do not remain at the same time. Their movements are hardly noticeable, but they are repeated with every step, with every inhalation and exhalation. Given that there are 230 joints in the human body, how much lubricant do they need and where does this lubricant come from? Having asked this question, Vishnevsky answered it himself. It turns out that the lubrication is supplied by a pearly white cartilaginous plate that protects the bones from friction. It does not have a single blood vessel, and yet the cartilage receives its nourishment from the blood. In its three layers there is an army of "builder" cells. The upper layer, which wears out due to the friction of the joints, is replaced by the lower ones. This is similar to what happens in the skin: with each movement, the clothes erase the dead cells of the surface layer, and they are replaced by the underlying ones. But the cartilage-former does not die ingloriously, like a cell skin. Death transforms him. It becomes soft and slippery, turning into a lubricant. So on the rubbing surface a uniform layer of "ointment" is formed. The more intense the load, the more "builders" die and the faster the lubricant is formed. Isn't this a hymn to walking!

After the first CABG operation, my weight was kept within 58-60 kg (with a height of 165 cm), I took medications only in emergency cases: with an increase in blood pressure, temperature, heart rate, headaches, arrhythmia. The main difficulty for me was my excitable nervous system, which I practically could not cope with, and this affected the results of the examinations. Sharp increase blood pressure and heart rate due to excitement misled doctors about my actual physical capabilities.

After analyzing the statistics of long-term physical training, I determined the optimal heart rate for my operated heart, which guarantees the safety and aerobic effect of physical exercises. My optimal heart rate is not unambiguous, like Cooper's, it has a wider aerobic range of values, depending on the type of physical activity. For gymnastic exercises - 94 beats / min; for dosed walking - 108 beats / min; for swimming and skiing - 126 beats / min. I rarely reached the upper limits of the pulse. The main criterion was that the recovery of the pulse to its original value took place, as a rule, quickly. I want to warn you: the optimal pulse recommended by Cooper for a 70-year-old man - 136 beats / min - after myocardial infarction and CABG surgery is unacceptable and dangerous! The results of long-term physical training every year confirmed that I was on the right track, and the conclusions made after the first CABG were correct.

Their essence is as follows:

The main thing for the operated is a deeply conscious understanding of the significance of the CABG operation, which saves the patient by restoring normal blood supply to the heart muscle, and gives him a chance for the future, but does not eliminate the cause of the disease - vascular atherosclerosis;

The operated heart (ACS) has great potential, manifesting itself with a properly selected lifestyle and physical training, which should be done constantly;

The heart, like any machine, needs to be trained, especially after a myocardial infarction, when more than 25% of the heart muscle has turned into a scar, and the need for a normal blood supply remains the same.

It was only thanks to my lifestyle and the system of physical training that I managed to maintain good physical shape and undergo a second CABG operation. Therefore, in any conditions, even in the hospital, I always tried not to stop physical training, albeit in a reduced volume (gymnastics - 10-15 minutes, walking around the ward and corridors). While in the hospital, and then at the Cardiology Research Center and the Russian Research Center for Surgery, I walked a total of 490 km before the second CABG operation.

Two of my four shunts, placed in March 1985, survived 14.5 years with physical training. This is quite a lot compared to the data of the article “Shunts are not eternal” (10 years) and the statistics of the Russian Scientific Center of Surgery (7-10 years). So the effectiveness of controlled physical activity in myocardial infarction and coronary artery bypass grafting seems to me proven. Age is not a hindrance. The need and volume of physical activity should be determined by the general condition of the operated patient and the presence of other diseases that limit his physical activity. The approach must be strictly individual. I was very lucky that next to me there was always an intelligent, sensitive and attentive doctor - my wife. She not only observed me, but also helped me overcome both medical illiteracy and fear of a possible negative reaction of the cardiovascular system to ever-increasing physical activity.

Experts say that repeated operations are a particular difficulty for surgeons around the world. My recovery after the second operation was not as smooth as the first time. Two months later, some signs of angina pectoris appeared with this type of exercise, such as dosed walking. And although they were easily removed by taking one tablet of nitroglycerin, this puzzled me greatly. Did I understand? that it is impossible to draw hasty conclusions - too little time has passed after the operation. Yes, and rehabilitation began in the sanatorium already on the 16th day (after the first operation, I started more or less active actions after 2.5 months). In addition, it was impossible not to take into account that I became 15 years older! All this is true, but if a person, thanks to his system, achieves certain positive results, he is inspired and confident in himself. And when suddenly fate throws him back, making him vulnerable and helpless, this is a tragedy associated with very strong feelings.

Pulling myself together, I began to work out a new program of life and physical training and quickly became convinced that my work was not in vain, since the basic approaches remained the same, but the volume and intensity of the loads would have to be increased more slowly, taking into account my new condition and in conditions of strict control over it. Starting with slow walks and 5-10-minute gymnastic warm-ups (head massage, rotational movements of the pelvis and head, inflation of the ball 5-10 times), 5 months after the operation, I increased physical activity to 50% of the previous ones: gymnastics for 1 hour 30 minutes (72 exercises, 2300 movements) and dosed walking for 1 hour 30 minutes at a pace of 105-125 steps per minute. I perform them only once in the morning, and not twice, as before. For 5 months after repeated shunting, he walked 867 km. At the same time, I conduct auto-training sessions twice a day, which help me relax, relieve stress and restore working capacity. So far, my gymnastic apparatus includes a chair, two gymnastic sticks, a ribbed roller, a roller massager and an inflatable ball. I stopped at these loads until the causes of angina manifestations were fully clarified.

Of course, the CABG operation itself, not to mention the repeated one, its unpredictable consequences, possible postoperative complications create great difficulties for the operated person, especially in organizing physical training. He needs help, and not just medicine. He needs a minimum of information about his disease in order to competently build a future life and avoid undesirable consequences. I almost did not come across the necessary information. Even M. DeBakey's book with the intriguing title "A New Life of the Heart" in the chapter "Healthy Lifestyle" talks mainly about eliminating risk factors and improving lifestyle (diet, weight loss, salt restriction, smoking cessation). Although the author pays tribute to physical exercises, he warns that excessive loads and sudden overloads can end tragically. But what is excessive load, how they are characterized and how to live with a “new heart”, nothing is said.

Articles by N.M. helped me to develop a competent approach to the organization of physical training. Amosov and D.M. Aronov, as well as K. Cooper and R. Gibbs, although all of them were devoted to the prevention of heart attack using jogging and did not affect CABG operations.

The main thing that I managed to do was to keep mental activity and creative activity, to maintain the spirit of vivacity and optimism, and all this, in turn, helped to find the meaning of life, faith in oneself, in one's ability to improve and self-discipline, in the ability to take responsibility for one's life in own hands. I believe that there is no other way and I will continue to continue my observations and experiments that help me overcome emerging health difficulties.

Arkady Blokhin

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Heart bypass surgery: history, first operation

What is a heart bypass? How long do they live after surgery? And most importantly, what do people who are lucky enough to get a second chance at a completely new life say about her?

Bypass is an operation performed on the vessels. It is it that allows you to normalize and restore blood circulation throughout the body and in individual organs. The first such surgical intervention was carried out in May 1960. Successful operation in execution American doctor Robert Hans Goetz passed in medical college named after A. Einstein.

What is the meaning of surgery

Shunting is the artificial creation of a new path for blood flow. Heart surgery in this case is performed using vascular shunts, which specialists find in the internal mammary artery of the patients themselves who need surgical intervention. In particular, for this purpose, doctors use either the radial artery in the arm or a large vein in the leg.

This is how heart bypass happens. What it is? How long people live after it - these are the main questions that are of interest to the suffering, facing problems of cardio-vascular system. We will try to answer them.

When should a heart bypass be performed?

According to many experts, surgical intervention is an extreme measure, which should be resorted to only in exceptional cases. One of these problems is considered to be coronary or coronary heart disease, as well as atherosclerosis similar in symptoms.

Recall that this disease is also associated with an excess amount of cholesterol. However, unlike ischemia, this ailment contributes to the creation of peculiar plugs or plaques that completely block the vessels.

Do you want to know how long people live after heart bypass surgery, and is it worth doing such an operation for people in old age? To do this, we have collected answers and advice from experts, which we hope will help you figure it out.

So, the danger of coronary disease and atherosclerosis lies in the excessive accumulation of cholesterol in the body, the excess of which inevitably affects the vessels of the heart and blocks them. As a result, they narrow and stop supplying the body with oxygen.

In order to return a person to normal life, doctors, as a rule, advise to carry out a heart bypass. How long patients live after surgery, how it goes, how long the rehabilitation process lasts, how the daily routine of a person who has undergone bypass surgery changes - all this should be known to those who are just thinking about a possible surgical intervention. And most importantly, you need to get a positive mental attitude. To do this, shortly before the operation, future patients should enlist the moral support of close relatives and have a conversation with their doctor.

What is a heart bypass?

Cardiac bypass, or CABG for short, is conventionally divided into 3 types:

• single;
• double;
• triple.

In particular, such a division into species is associated with the degree of damage to the human vascular system. That is, if a patient has a problem with only one artery that needs a single bypass, then this is a single bypass, with two - a double, and with three - a triple heart bypass. What it is, how many people live after surgery, can be judged by some reviews.

What preparatory procedures are carried out before shunting?

Before the operation, the patient must undergo coronary angiography (a method for diagnosing coronary heart vessels), pass a series of tests, obtain a cardiogram and ultrasound examination data.

The preoperative preoperative process itself begins approximately 10 days before the announced bypass date. At this time, along with testing and examination, the patient is taught a special breathing technique, which will later help him recover from the operation.

How long does the operation take?

The duration of CABG depends on the condition of the patient and the complexity of the surgical intervention. As a rule, the operation is performed under general anesthesia, and in time it takes from 3 to 6 hours.

Such work is very time-consuming and exhausting, so a team of specialists can perform only one heart bypass. How long they live after surgery (the statistics given in the article allows you to find out) depends on the experience of the surgeon, the quality of CABG and the recovery capabilities of the patient's body.

What happens to the patient after the operation?

After surgery, the patient usually ends up in intensive care, where he undergoes a short course of restorative breathing procedures. Depending on the individual features and the possibilities of each, a stay in intensive care may well stretch for 10 days. Then the operated person is sent for subsequent recovery to a special rehabilitation center.

Seams, as a rule, are carefully treated with antiseptics. In case of successful healing, they are removed for about 5-7 days. Often in the area of ​​\u200b\u200bthe seams there is a burning sensation and pulling pain. After about 4-5 days, all side effects disappear. And after 7-14 days, the patient can already take a shower on his own.

Bypass Statistics

Various studies, statistics and sociological surveys of both domestic and foreign specialists speak of the number of successful operations and people who have undergone this and completely changed their lives.

According to ongoing studies regarding bypass surgery, death was observed in only 2% of patients. The case histories of approximately 60,000 patients were taken as the basis for this analysis.

According to statistics, the most difficult is the postoperative process. In this case, the survival process after a year of life with an updated respiratory system is 97%. At the same time, a number of factors affect the favorable outcome of surgical intervention in patients, including individual tolerance to anesthesia, the state of the immune system, and the presence of other diseases and pathologies.

In this study, the experts also used data from the medical history. This time 1041 people took part in the experiment. According to the test, approximately 200 of the studied patients not only successfully endured the implantation of implants into their bodies, but also managed to live to the age of ninety.

Does heart bypass help with heart defects? What it is? How many people live with heart disease after surgery? Similar topics are also of interest to patients. It is worth noting that in severe cardiac anomalies, surgery can become an acceptable option and significantly prolong the life of such patients.

Heart bypass surgery: how long do they live after surgery (reviews)

Most often, CABG helps people live without problems for several years. Contrary to the erroneous opinion, the shunt created during surgery does not clog even after ten years. According to Israeli experts, implantable implants can last 10-15 years.

However, before agreeing to such an operation, it is worth not only consulting with a specialist, but also studying in detail the reviews of those people whose relatives or friends have already used the unique bypass method.

For example, some patients who underwent heart surgery claim that after CABG they experienced relief: it became easier to breathe, and pain in chest area disappeared. Hence, heart bypass surgery helped them a lot. How many people live after the operation, reviews of people who actually got a second chance - you will find information about this in this article.

Many argue that their relatives took a long time to recover from anesthesia and recovery procedures. There are patients who say that they underwent surgery 9-10 years ago and are now feeling well. In this case, heart attacks did not recur.

Do you want to know how long people live after heart bypass surgery? Reviews of people who have undergone a similar operation will help you with this. For example, some argue that it all depends on the specialists and their skill level. Many are satisfied with the quality of such operations carried out abroad. There are reviews of domestic mid-level health workers who personally observed patients who underwent this complex intervention, who were already able to move independently by 2-3 days. But in general, everything is purely individual, and each case should be considered separately. It happened that the operated active image life after more than 16-20 years after they underwent coronary artery bypass grafting. What is it, how many people live after CABG, now you know.

What do experts say about life after surgery?

According to cardiac surgeons, after a heart bypass surgery, a person can live 10-20 years or more. Everything is purely individual. However, according to experts, for this it is necessary to regularly visit the attending physician and cardiologist, be examined, monitor the condition of the implants, observe special diet and engage in moderate but daily physical activity.

According to leading doctors, not only elderly people, but also younger patients, for example, those with heart disease, may need surgical intervention. They assure that the young body recovers faster after the operation and the healing process is more dynamic. But this does not mean that you should be afraid to do bypass surgery in adulthood. According to experts, heart surgery is a necessity that will extend life by at least 10-15 years.

Summary: as you can see, how many years people live after heart bypass surgery depends on many factors, including the individual characteristics of the body. But the fact that the chance to survive is worth taking advantage of is an indisputable fact.

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How important is rehabilitation after heart bypass surgery?

After the operation, the manifestations of coronary heart disease decrease in patients, but the cause of its occurrence does not disappear. State vascular wall and the level of atherogenic fats in the blood does not change. This means that there remains a risk of narrowing of other branches of the coronary arteries and a deterioration in well-being with the return of previous symptoms.

In order to fully return to a full life and not feel anxious about the risk of developing vascular crises, all patients need to complete a full course rehabilitation treatment. This will help keep normal function new shunt and prevent it from closing.

Goals of rehabilitation after vascular bypass surgery

Cardiac bypass surgery is a serious surgical intervention, so rehabilitation measures are aimed at different aspects of patients' lives. The main tasks are the following:

What kind of rehabilitation is needed in the first days after the operation

After the transfer of the patient from the intensive care unit to a regular ward, the main the direction of recovery is the normalization of breathing and the prevention of congestion in the lungs.

Vibration massage is carried out over the area of ​​the lungs with light tapping movements. As often as possible, you need to change position in bed, and after the permission of the surgeon, lie down on your side.

It is important to gradually increase physical activity. To do this, depending on how they feel, patients are advised to sit on a chair, then walk around the ward, corridor. Shortly before discharge, all patients should independently climb the stairs and walk in the fresh air.

After arriving home: when to see a doctor urgently, scheduled visits

Usually, at discharge, the doctor sets the date for the next scheduled consultation (in 1-3 months) at the medical institution where the surgical treatment was performed. This takes into account the complexity and volume of shunting, the presence of pathology in the patient, which can complicate the postoperative period. Within two weeks, you need to visit the local doctor for follow-up preventive monitoring.

If there are signs of possible complications, then a cardiac surgeon should be contacted immediately. These include:

• signs of inflammation of the postoperative suture: redness, increased pain, discharge;
• increase in body temperature;
• increasing weakness;
• labored breathing;
• sudden increase in body weight, swelling;
• attacks of tachycardia or interruptions in the work of the heart;
• severe chest pain.

Life after heart bypass surgery

The patient must understand that the operation was done in order to gradually normalize blood circulation and metabolic processes. This is possible only if you pay attention to your condition and switch to a healthy lifestyle: bad habits, increased physical activity and proper nutrition.

Diet for a Healthy Heart

The main factor in circulatory disorders in myocardial ischemia is an excess of cholesterol in the blood. Therefore, it is necessary to exclude animal fats, and add foods to the diet that can remove it from the body and prevent the formation of atherosclerotic plaques.

Prohibited products include:

• pork, lamb, offal (brains, kidneys, lungs), duck;
• most sausages, canned meat, semi-finished products, ready minced meat;
• fatty varieties of cheese, cottage cheese, sour cream and cream;
• butter, margarine, all purchased sauces;
• fast food, chips, snacks;
• confectionery, sweets, white bread and pastries, puff pastry;
• all fried foods.

The diet should be dominated by vegetables, best in the form of salads, fresh herbs, fruits, fish dishes, seafood, boiled beef or chicken without fat. It is better to prepare the first courses as vegetarian, and add meat or fish when serving. Dairy products should be chosen low fat, fresh. Useful fermented milk drinks home cooking. Vegetable oil is recommended as a source of fat. Its daily norm is 2 tablespoons.

A very useful component of the diet is bran from oats, buckwheat or wheat. Such a food supplement will help normalize bowel function, remove from the body excess amount sugar and cholesterol. They can be added starting with a teaspoon and then increased to 30 g per day.

For information on what foods are best to eat after heart surgery, see this video:

Nutrition and water balance rules

Diet food should be fractional - food is taken in small portions 5 - 6 times a day. Between the three main meals, you need 2 or 3 snacks. For cooking, boiling in water, steaming, stewing and baking without oil is used. With excess body weight, calorie content is necessarily reduced, and a fasting day is recommended once a week.

An important rule is the restriction of table salt. Dishes are not allowed to be salted during cooking, and the entire norm of salt (3-5 g) is handed out. Liquid should also be taken in moderation - 1 - 1.2 liters per day. This volume does not include the first course. Coffee, strong tea, cocoa and chocolate are not recommended, as well as sweet carbonated drinks, energy drinks. An absolute ban is imposed on alcohol.

Physical exercise in the postoperative period

The most accessible form of exercise after surgery is walking. It allows you to gradually increase the level of fitness of the body, it is easy to dose, changing the duration and pace. If possible, these should be walks in the fresh air, with a gradual increase in the distance traveled. At the same time, it is important to control the heart rate - not higher than 100 - 110 beats per minute.

Special complexes of therapeutic gymnastics can also be used, which at first do not put a load on the shoulder girdle. After complete healing of the sternum, you can go swimming, running, cycling, dancing. You should not choose sports with a load on the chest - basketball, tennis, weight lifting, pull-ups or push-ups.

Can I smoke?

Under the influence of nicotine, the following changes occur in the body:

The influence of smoking on the progression of coronary disease is manifested even with a minimum amount of cigarettes smoked, which leads to the need to completely abandon this bad habit. If the patient ignores this recommendation, then the success of the operation can be reduced to zero.

How to drink drugs after heart bypass surgery

After shunting continues drug therapy which focuses on the following aspects:

• maintaining a normal level of blood pressure and heart rate;

• lowering the level of cholesterol in the blood;
• preventing the formation of blood clots;

• improved nutrition of the heart muscle.

Intimate life: is it possible, how and from what moment

Return to full-fledged sexual relations depends on the patient's condition. Usually there are no contraindications to intimate contacts. In the first 10-14 days after discharge, excessively intense physical activity should be avoided and postures should be chosen in which there is no pressure on the chest.

After 3 months, such restrictions are removed, and the patient can only focus on own desires and needs.

When can I go to work, are there any restrictions

If the view labor activity involves work without physical exertion, then you can return to it 30-45 days after the operation. This applies to office workers, persons of intellectual labor. Other patients are advised to switch to milder conditions. In the absence of such an opportunity, it is necessary either to extend the rehabilitation period, or to undergo an examination of working capacity to determine the disability group.

Recovery in a sanatorium: is it worth going?

The best results can be obtained if the recovery takes place in specialized cardiological sanatoriums. In this case, the patient is prescribed complex treatment and diet, physical activity, which cannot be qualified independently.

The big advantages are the constant supervision of doctors, the impact of natural factors, psychological support. With sanatorium treatment, it is easier to acquire new useful skills for life, to give up junk food, smoking, and drinking alcohol. There are special programs for this.

Chance to travel after surgery

It is allowed to drive a car a month after bypass surgery, subject to a stable improvement in well-being.

All long-distance trips, especially flights, must be agreed with your doctor. They are not recommended in the first 2 to 3 months. This is especially true of a sharp change in climatic conditions, time zones, travel to high mountain areas.

Before a long business trip or vacation, it is advisable to undergo a cardiological examination.

Disability after heart bypass surgery

A referral for a medical examination is issued by a cardiologist at the place of residence. The medical commission analyzes the patient's documentation: an extract from the department, the results of laboratory and instrumental research, and also examines the patient, after which a disability group can be determined.

Most often, after vascular bypass surgery, patients receive a temporary disability for one year, and then it is confirmed again or removed. Approximately 7-9 percent of the total number of operated patients need such restrictions on work.

Which of the patients can apply for a disability group?

The first group is determined for patients who, due to frequent attacks of angina pectoris and manifestations of heart failure, need outside help.

Ischemic disease with daily attacks and insufficiency of the functioning of the heart of 1-2 classes suggest the assignment of the second group. The second and third groups can be working, but with limited loads. The third group is given for moderate disorders of the heart muscle, which interfere with the performance of normal work activities.

Thus, it can be concluded that after heart bypass surgery, patients can return to a full life. The result of rehabilitation will depend on the patient himself - how much he can give up bad habits and change his lifestyle.

cardiobook.ru How to strengthen the heart and heart muscle

Coronary artery bypass grafting (CABG) is one of the the most complex operations in cardiovascular surgery, requiring a complex of rehabilitation measures aimed at preventing complications, adapting the patient and his speedy recovery.

Let's take a closer look at why rehabilitation is important after CABG?

Bypass surgery is performed when a vessel or duct is not functional in the body. This method creates an additional path around the affected area using shunts. Most often they talk about shunting of blood vessels, but the operation can be performed on the ducts. gastrointestinal tract and (very rarely) in the ventricular system of the brain.

During shunting of blood vessels, the patency of the artery for blood flow is restored. The operation should be distinguished from vascular stenting - in this method, the vessel is restored by implanting a tubular structure into its walls.

When is bypass performed?

This surgery is indicated for the following conditions:

1. myocardial infarction;
2. coronary insufficiency;
3. cardiac ischemia;
4. refractory angina;
5. unstable angina;
6. stenosis of the trunk of the left coronary artery;
7. as a concomitant operation during surgical interventions on the heart valves, coronary arteries.

Coronary artery bypass grafting is indicated for coronary insufficiency, which is the basis of coronary heart disease. The condition is characterized by the fact that the coronary vessels (feeding the heart muscle) are affected by atherosclerosis. On the inner wall arteries, atherosclerotic plaques are deposited, as they increase, they close the lumen of the blood path, which disrupts the nutrition of a certain area of ​​\u200b\u200bthe myocardium. In the future, this can lead to necrosis - tissue necrosis with a complete disruption of functioning.

Coronary insufficiency leads to coronary artery disease. Pathology is a violation of the activity of the heart muscle due to a sharp decrease in the supply of oxygen to blood cells. Ischemic heart disease can occur in the acute phase (myocardial infarction) or chronic (angina pectoris - attacks of acute pain behind the sternum or in the region of the heart).

What is the essence of the operation?

Before the intervention, the patient is prescribed coronography (analysis of the state of myocardial vessels), complex ultrasound and angiography (X-ray scanning of arteries and veins) to take into account the individual characteristics of the person in the upcoming operation.

Coronary is performed under general anesthesia. The site of the saphenous veins of the thigh is usually chosen as the material for the shunt, since the removal of part of this vessel does not affect the functioning of the lower extremities. The veins of the thigh have a large diameter and are less susceptible to atherosclerotic changes. The second option is a section of the radial artery of the non-dominant hand of a person. In surgical practice, artificial shunts made of synthetic materials are also used.

The operation is carried out on open heart, sometimes - on the beating one, using the artificial blood circulation system, and lasts 3-4 hours. The surgeon decides how to perform the operation. Depends on the degree of vascular damage and possible aggravating factors (the need to replace valves, aneurysm).

Why is rehabilitation after CABG so important?

There are several important reasons for this:

• Heart bypass surgery is a traumatic operation, performed on patients (most often the elderly) with poor health, and therefore recovery is difficult.
• After coronary artery bypass grafting, complications are possible, most often - sticking of the shunts. Almost 90% of shunts stick together within 8-10 years, and repeated surgical intervention is required.
• Availability comorbidities in the elderly may reduce the effectiveness of recovery.

Rehabilitation after coronary artery bypass surgery

The leading principles of recovery in the postoperative period are phasing and continuity.

First stage

Lasts 10-14 days from the date of surgery.

At first, the patient is on a ventilator. When the patient begins to breathe on his own, the supervising physician must ensure that there are no congestion in the lungs.

The next event is the dressing and treatment of wounds on the arm or thigh, depending on where the shunt material was taken from, and wounds of the sternum. During open heart surgery, the sternum is incised, which is then held together with metal sutures. The sternum is a bone that is difficult to heal, on full recovery may take up to 6 months. To ensure rest and strengthen the bones, special medical bandages (corsets) are used. Postoperative bandage- a special belt made of elastic material with ties and fasteners. Protects the seams from divergence, fixes the chest, minimizes pain; tightly clasping the intercostal muscles, the corset reduces the physiological load on them and fixes the organs of the mediastinum and chest.

There are men's and women's corsets. When choosing a bandage, it is necessary to take into account the individual characteristics of the patient. An appropriate width should be chosen so that the postoperative suture is completely covered, and the girth of the corset is equal to the girth of the patient's chest. The bandage material should be natural, breathable, moisture-releasing and hypoallergenic. The corset is worn in a supine position, over the patient's clothes. The chest bandage has to be worn for up to 4-6 months, in some cases longer.

Drug therapy after CABG at the initial stage is aimed at preventing the consequences of anemia due to blood loss and at stimulating cardiac activity.

The following groups of drugs are used:

• aspirin;
• anaprilin, metoprolol, bisoprolol, carvedilol, nadolol - reduce the heart rate and blood pressure, protecting the heart weakened after surgery from stress under the action of adrenaline;
• captopril, enalapril, ramipril, fosinopril - reduce heart pressure due to the expansion of blood vessels, they act similarly to vasodilators;
• statins (simvastatin, lovastatin, atorvastatin, rosuvastatin) - inhibit the formation of cholesterol and have become indispensable helpers in atherosclerosis, which is a prerequisite for the development of coronary heart disease.

The physical rehabilitation of patients is especially important. In the first days after the operation, the patient is allowed to get out of bed, move around the hospital ward, and do elementary exercises for the arms and legs. After a few days, the patient can take walks along the corridor, accompanied by relatives or nurse. Then light gymnastics is assigned.

Walks gradually increase, after a week the patient walks about 100 meters. The state of a person is necessarily noted: heart rate and blood pressure are measured at rest, during exercise and after rest. Motor activity must be alternated with periods of rest.

Useful moderate walking on the stairs. After this type of physical education, functional tests are carried out, the patient's well-being is monitored.

The therapy is accompanied laboratory tests:

• regular electrocardiograms;
• daily measurements of blood pressure and heart rate;
• control of the components of the blood-clotting system, bleeding time and coagulation;
• general blood analysis;
• general urine analysis.

Second phase

The patient independently carries out a complex of physiotherapy exercises.

Added to procedures massotherapy, laser therapy, magnetotherapy, the effect of therapeutic electric currents on the heart area and postoperative scars; electrophoresis.

Mandatory control over the patient's condition, conducting tests, clinical analyzes, wearing a bandage - as in the first period after heart surgery.

Third stage

The third stage of rehabilitation begins from 21-24 days after surgery.

The patient is transferred to simulators for cardio training. Physical activity gradually increases. The choice of exercise regimen and the degree of increase in intensity depends on the fitness of the person, on how the recovery goes, on the state of postoperative scars.

Medical massage continues, laser therapy, electrotherapy, electrophoresis of medicines are used.

The course lasts 15-20 days.

Fourth stage

The fourth stage of rehabilitation takes place within 1-2 months from the moment of surgery.

It is recommended to carry out this stage of recovery in sanatoriums, health resorts and other resort and preventive institutions. The sanatorium regime is aimed at the speedy recovery of patients, the treatment of concomitant diseases, and the improvement of the overall quality of life. Walks in the fresh air, a specially selected diet help to improve the condition, help to quickly return to the previous active life.

Physical therapy and cardio training continue on specially selected simulators, individual sets of exercises are being developed for patients so that convalescents can do them at home.

Specialists of medical institutions carry out constant monitoring of the progress of recovery, measures to prevent complications and the development of atherosclerosis, recovery functional activity heart and his compensatory mechanisms, consolidation of the results of the treatment, preparation of patients for everyday life and former life (psychological, social and labor rehabilitation).

It is important to follow the diet: foods rich in nitrogen are excluded from the diet of people who have undergone CABG surgery; meat, poultry and fish are steamed, limit the use of simple carbohydrates (flour and confectionery, sugar, honey). It is recommended to consume more fresh fruits and vegetables, especially those containing potassium. Useful eggs, milk and dairy products. And it is especially important to exclude foods rich in cholesterol.

Rehabilitation after heart bypass surgery is a long and laborious process, however, the phased implementation of the recommendations and competent help specialists returns almost all patients after CABG to active life.

Bypass is an operation on the vessels, it was first performed in the late 60s by two cardiac surgeons from Cleveland - Favoloro and Efler.

What is shunting?

Shunting (eng. shunt - branch) is an operation that consists in the fact that physicians create an additional path for blood flow to bypass a section of a vessel or organ using a system of shunts (grafts). Bypass surgery is done to restore normal blood flow in the vessels (heart, brain) or restore normal operation organ (stomach).

What are the types of shunting?

Shunting of the blood vessels of the heart- the introduction of a transplant around the affected area of ​​the vessel. Vascular grafts (shunts) are taken from the patients themselves from the internal mammary artery, the great saphenous vein in the leg, or the radial artery in the arm.

Gastric bypass is a completely different operation: the organ cavity is divided into two parts, one of which is connected to the small intestine, which is responsible for the absorption of nutrients. Thanks to this operation, part of the stomach becomes unused in the process of digestion, so the body is saturated faster, and the person quickly loses extra pounds.

During gastric bypass surgery, the surgeon does not remove anything, only the shape of the gastrointestinal tract is changed. The purpose of gastric bypass surgery is to correct excess weight.

Shunting of the arteries of the brain is a surgical operation aimed at restoring blood flow in the vessels of the brain. Brain bypass surgery is similar to heart bypass surgery for coronary artery disease. A vessel that is not involved in the blood supply to the brain is connected to an artery located on its surface.

The result of the operation is the redirection of blood flow around the clogged or narrowed artery. The main goal of bypass surgery is to restore or preserve the blood supply to the brain. Prolonged ischemia leads to the death of brain cells (neurons), which is called cerebral infarction (ischemic stroke).

For what diseases is shunting performed?

The presence of cholesterol plaques in the vessels (atherosclerosis). In a healthy person, the walls of blood vessels and arteries are a smooth surface without any barriers and constrictions. In a person with atherosclerosis, there is a blockage of blood vessels due to cholesterol plaques. If the disease is started, it can lead to the necrosis of tissues and organs.

Cardiac ischemia. The traditional case of bypass surgery is coronary (ischemic) heart disease, in which coronary arteries that feed the heart are affected by cholesterol deposits in the bloodstream of the vessel. The main symptom of this disease is the narrowing of the lumen of the vessels, which leads to an insufficient supply of oxygen to the heart muscle. In such a situation, there are often complaints of pain behind the sternum or in the left half of the chest, the so-called angina pectoris or angina pectoris.

The presence of excess weight. A shunt inserted into the stomach divides it into large and small. Small connects with small intestine, as a result of which the volume of food eaten and the absorption of nutrients are significantly reduced.

Violation of blood flow in the vessels of the brain. Insufficient blood supply to the brain (ischemia) can be both limited and global. Ischemia disrupts the ability of the brain to function normally and, when neglected, can lead to tumors or brain infarction. Treatment of cerebral ischemia is carried out by a neurologist in a hospital with the help of medications ( vasodilators, anti-clotting and blood thinning drugs, nootropic drugs to improve brain function) or through surgery (in the advanced stages of the disease).

Results of coronary artery bypass surgery

Creation of a new section of the vessel in the process of shunting qualitatively changes the patient's condition. Due to the normalization of blood flow to the myocardium, his life after heart bypass surgery changes for the better:

1. The attacks of angina pectoris disappear;
2. The risk of a heart attack is reduced;
3. Improves physical condition;
4. Work capacity is restored;
5. The safe volume of physical activity increases;
6. Reduces the risk of sudden death and increases life expectancy;
7. The need for medicines is reduced only to a preventive minimum.

In a word, after CABG, a sick person becomes available usual life healthy people. Reviews of cardioclinic patients confirm that bypass surgery returns them to a full life.

According to statistics, in 50–70% of patients after surgery, almost all disorders disappear, in 10–30% of cases the condition of patients improves significantly. New blockage of blood vessels does not occur in 85% of those operated on.

Of course, any patient who decides to undergo this operation is primarily concerned with the question of how long they live after heart bypass surgery. This is a rather complicated question, and no doctor will take the liberty of guaranteeing a specific period. The prognosis depends on many factors: the general health of the patient, his lifestyle, age, the presence of bad habits, etc. One thing is for sure: a shunt usually lasts about 10 years, with younger patients having a longer lifespan. Then a second operation is performed.

Life after

A person who has passed the edge of danger and stayed alive understands how long he will have to live on this earth after the operation depends on him. How do patients live after surgery, what can we hope for? How, how long will shunting take to life?

There can be no single answer, due to different physical condition organism, the timeliness of surgical intervention, the individual characteristics of a person, the professionalism of surgeons, the implementation of recommendations during the recovery period.

In principle, the answer to the question: “How long do they live?” there is. You can live 10, 15 or more years. It is necessary to monitor the condition of shunts, visit a clinic, consult a cardiologist, get examined on time, follow a diet, and lead a calm lifestyle.

Important criteria will be character traits of a person - positivity, cheerfulness, efficiency, desire to live.

Sanatorium treatment

After surgery, restoring health is indicated in specialized sanatoriums under the supervision of trained medical personnel. Here the patient will receive a course of procedures aimed at restoring health.

Diet

A positive result after surgery depends on many reasons, including adherence to a special diet. Heart bypass surgery is a serious intervention in the life of the body, and therefore has certain obligations that the patient must fulfill, these are:

• doctor's recommendations;
• to withstand the regime of the recovery period in intensive care;
• complete rejection of bad habits like smoking and alcohol;
• refusal of the usual diet.

When it comes to dieting, don't worry. The patient moves away from the usual homemade food and proceeds to the complete exclusion of foods containing fats - these are fried foods, fish, butter, margarine, ghee and vegetable oils.

After surgery, it is recommended to include more fruits and fresh vegetables. Every day you should take a glass of freshly squeezed orange juice (fresh). Walnuts and almonds will brighten up the diet with their presence. Any fresh berries will not interfere, blackberries are especially useful for the heart, supplying antioxidants to the body. These elements lower the level of cholesterol coming from food.

You can not eat fatty dairy products, except skimmed milk and low fat cheeses. It is recommended no more than 200 grams of kefir per day, but low-fat. After the operation, Coca-Cola, Pepsi, sweet soda are excluded. Filtered water, mineral water will be used for a long time. In small quantities, tea, coffee without sugar or sucrose are possible.

Take care of your heart, take care of it more, observe the culture of proper nutrition, do not abuse alcoholic drinks that will lead to the development cardiovascular disease. Complete rejection of bad habits. Smoking, alcohol destroy the walls of blood vessels. Implanted shunts "live" no more than 6-7 years and need special care and attention.

Operation cost

Such a modern and effective method of restoring blood flow that supplies the heart muscle, like coronary artery bypass grafting, has a rather high cost. It is determined by the complexity of the operation and the number of bypasses, the patient's condition and the quality of rehabilitation that he expects after the operation. The level of the clinic in which the operation will be performed also affects how much the bypass surgery costs: in a private specialized clinic, it will cost clearly more than in a regular cardiology hospital. You will need a lot of money for coronary artery bypass grafting - the cost in Moscow fluctuates within 150,000-500,000 rubles. When asking about heart bypass surgery, how much it costs in clinics in Israel and Germany, you will hear the numbers are much higher - 800,000-1,500,000 rubles.

What awaits you after heart surgery? What loads are allowed and when? How will the return to normal life? What should I pay attention to in the hospital and at home? When can you return to a fulfilling sex life, and when can you wash your own car? What and when can you eat and drink? What medicines to take?

All answers are in this article.

After heart surgery, you will probably feel that you have been given another chance - a new permission to live. You may think that you can get the most out of your "new life" and the best results from your surgery. If you're having coronary bypass surgery, it's important to consider making lifestyle changes, such as losing 5 pounds or starting regular exercise. This should be taken seriously and you should talk to your doctor about the risk factors. There are books on health and cardiovascular disease that should guide your new life. The days ahead will not always be easy. But you must steadily move forward to recuperation and recovery.

In the hospital

In the inpatient department, your activity will increase every day. In addition to sitting on a chair, a walk around the ward and in the hall will be added. Deep breathing to clear the lungs, and exercises for the arms and legs must continue.

Your doctor may recommend wearing elastic stockings or bandages. They help blood return from the legs to the heart, thereby reducing swelling in the legs and feet. If the femoral vein was used for coronary artery bypass grafting, slight swelling of the legs in recovery period- quite normal. Elevating your leg, especially when you are sitting, helps lymphatic and venous blood flow and reduces swelling. When you lie down, you should take off the elastic stockings 2-3 times for 20-30 minutes.
If you tire quickly, frequent activity breaks are part of your recovery. Feel free to remind your family and friends that visits should be short.
There may be muscle pain and short pains or itching in the wound area. Laughter, blowing your nose can cause short-term, but noticeable discomfort. Be sure - your sternum is sewn very securely. Pressing a pillow against your chest can reduce this discomfort; use it when coughing. Feel free to ask for painkillers when you need them.

You may sweat at night even though the temperature is normal. This night sweating is normal for up to two weeks after surgery.
Possible pericarditis - inflammation of the pericardial sac. You may feel pain in your chest, shoulders, or neck. Your doctor will usually prescribe aspirin or indomethacin to treat you.

In some patients, the heart rhythm is disturbed. If this happens, you will need to take medication for a while until the rhythm returns.

Mood swings are common in patients after open-heart surgery. You can be in a joyful mood immediately after the operation, and become sad, irritable during the recovery period. Sad mood, explosions of irritability cause anxiety in patients and relatives. If emotions become a problem for you, talk to your nurse or doctor about it. Mood swings have been found to be a normal response, even if they continue for several weeks after discharge. Sometimes patients complain of changes in mental activity - it is harder for them to concentrate, memory weakens, attention is scattered. Don't worry, these are temporary changes and should disappear within a couple of weeks.

Houses. What to expect?

The patient is usually discharged from the hospital on the 10-12th day after the operation. If you live more than an hour away from the hospital, take breaks every hour along the way, get out of the car to stretch your legs. Prolonged sitting impairs blood circulation.

While your recovery in the hospital probably went fairly quickly, further recovery at home will be slower. It usually takes 2-3 months to fully return to normal activity. The first few weeks at home can be tough for your family, too. After all, those close to you are not used to the fact that you are "sick", they have become impatient, your mood may fluctuate. Everyone needs to try to make this period go as smoothly as possible. It will be much easier to cope with the situation if you and your family can openly, without reproaches and showdown, talk about all the needs, join forces to overcome critical moments.

Meetings with a doctor

It is necessary that you be observed by your regular attending physician (therapist or cardiologist). Your surgeon may also want to see you after you leave in a week or two. Your doctor will prescribe a diet, medicines will determine permissible loads. For questions related to the healing of postoperative wounds, you should contact your surgeon. Find out before discharge where to go for any possible situations. See your primary care physician immediately after discharge.

Diet

Since you may experience loss of appetite at first, and good nutrition has importance while your wounds are healing, you may be sent home with an unlimited diet. After 1-2 months, you will most likely be advised a diet low in fat, cholesterol, sugar, or salt. If you are suffering overweight, calories will be limited. A quality diet for most heart conditions limits cholesterol, animal fats, and foods high in sugar. It is advisable to eat food with a high number carbohydrates (vegetables, fruits, sprouted grains), fiber and healthy vegetable oil.

Anemia

Anemia (anemia) is a common condition after any surgical intervention. It can be eliminated, at least partially, by eating foods rich in iron, such as spinach, raisins, or lean red meat (the latter in moderation). Your doctor may recommend taking iron tablets. This medication can sometimes irritate the stomach, so it's best to take it with food. Be aware that this can darken the stool and cause constipation. Eat more fresh vegetables and fruits and you will avoid constipation. But if constipation has become persistent, ask your doctor to help with medication.

Wound and muscle pain

Discomfort due to pain in the postoperative wound and muscles may persist for some time. Sometimes anesthetic ointments help if they massage the muscles. Ointment should not be applied to healing wounds. If you feel clicking movements of the sternum, notify the surgeon. Itching in the area of ​​a healing wound is caused by hair regrowth. If the doctor allows, then a moisturizing lotion will help in this situation.

Call your doctor if you notice the following symptoms of an infection:

• temperature above 38°C (or less, but lasting more than a week),

• wetting or discharge of fluid from postoperative wounds, persistent or new appearance of swelling, redness in the area of ​​the postoperative wound.

Shower

If the wounds are healing, there are no open areas and no getting wet, you can decide to take a shower 1-2 weeks after the operation. Use plain warm soapy water to clean wounds. Avoid bubble bath, very hot and very cold water. When you wash for the first time, it is advisable to sit on a chair under the shower. Gently touching (not wiping, but soaking), drain postoperative wounds with a soft towel. For a couple of weeks, try to have someone nearby when you bathe or shower.

General guidelines for homework

Gradually increase activity every day, week and month. Listen to what your body is saying; rest if you are tired or short of breath, feel chest pain. Discuss the instructions with your doctor and take into account the comments or changes made.

• If instructed, continue to wear elastic stockings, but remove them at night.

• Plan your rest periods during the day and get a good night's sleep.

• If you're having trouble sleeping, it could be because you can't get comfortable in bed. By taking a painkiller at night, you can rest.

• Keep exercising your arms.

• Shower if the wound is healing normally and there are no weeping or open areas on the wound. Avoid very cold and very hot water.

First week at home

• Walk 2-3 times a day on flat terrain. Start at the same time and the same distance as the last days in the hospital. Increase the distance and time, even if you have to stop a couple of times short rest. 150-300 meters is within your power.

• Take these walks at the most convenient time of the day (this also depends on the weather), but always before meals.

• Choose some quiet, non-fatiguing activity: draw, read, play cards or solve crossword puzzles. Active mental activity is beneficial for you. Try walking up and down stairs, but don't go up and down stairs often.

• Travel with someone a short distance in a car.

Second week at home

• Pick up and carry light objects (less than 5 kg) for a short distance. Distribute the weight evenly on both hands.

• Gradually return to sexual activity.

• get busy light homemade work: dust, set the table, wash dishes or help with cooking while seated.

• Increase walking to 600-700 meters.

Third week at home

• Take care of household chores and yard work, but avoid stress and long periods of bending over or working with your arms up.

• Start walking longer distances - up to 800-900 meters.

• Accompany others on short shopping trips by car.

Fourth week at home

• Gradually increase your walks to 1 km per day.

• Lift things up to 7 kg. Load both hands equally.

• If your doctor allows, start driving short distances yourself.

• Do daily chores like sweeping, vacuuming for a short time, washing the car, cooking.

Fifth - eighth week at home

At the end of the sixth week, the sternum should heal. Keep increasing your activity. Your doctor will order an exercise test around the sixth to eighth week after surgery. This test will establish exercise fitness and will serve as a basis for quantifying increases in activity. If there are no contraindications and your doctor agrees, you can:

• Continue to increase your walking distance and speed.

• Lift things up to 10 kg. Load both hands equally.

• Play tennis, swim. Take care of the lawn, weeds and work with a shovel in the garden.

• Move furniture (light objects), drive a car for longer distances.

• Return to work (part-time) unless it involves heavy physical labor.

• By the end of the second month, you will probably be able to do everything that you did before the operation.

If you were working before the operation, but have not yet returned, it's time to do it. Of course, it all depends on your physical condition and type of work. If the work is sedentary, you will be able to return to it faster than to heavy physical work. A second stress test can be performed three months after surgery.

Sex after surgery

Often, patients wonder how the operation will affect their sexual relationship and are relieved to learn that most people gradually return to their previous sexual activity. It is recommended to start small - hugs, kisses, touches. Go to a full sexual life only when you stop being afraid of physical inconvenience.

Sexual intercourse is possible 2-3 weeks after surgery, when you are able to walk 300 meters at an average speed or climb stairs one floor without chest pain, shortness of breath or weakness. The heart rate and energy expenditure during these activities is comparable to the energy expenditure during sexual intercourse. Certain positions (for example, on the side) may be more comfortable at first (until the wounds and sternum are completely healed). It is important to rest well and be in comfortable position. For sexual activity, it is recommended to avoid the following situations:

• Being overly tired or agitated;

• Have sex after drinking more than 50-100 grams of a strong alcoholic drink;

• Overload with food during the last 2 hours before the act;

• Stop if chest pain appears. Some shortness of breath is normal during intercourse.

Medication

Many patients after surgery need drug treatment. Take your medicines only as directed by your doctor and never stop taking them without talking to your doctor. If you forget to take a pill today, do not take two at once tomorrow. It is worth having a schedule for taking medications and marking each dose in it. You should know the following about each of the prescribed drugs: the name of the drug, the purpose of the exposure, the dose, when and how to take it, possible side effects.
Keep each medicine in its container and out of reach of children. Do not share medicines with other people because they may be harmed by them. It is recommended that you keep a list of your medications in your wallet at all times. This will come in handy if you go to a new doctor, get hurt in an accident, pass out outside the home.

Medicines to prevent the formation of blood clots (blood clots)

Antiplatelet agents

These are "bad" cholesterol lowering pills that can reduce triglycerides and increase "good" cholesterol. Should be taken after dinner.

• Eat fruits and vegetables more often. Try to keep them always at hand (in the car, at the desktop).

• Eat lettuce, tomatoes, cucumbers and other vegetables at every meal.

• Try adding one new vegetable or fruit each week.

• For breakfast, eat porridge with bran (for example, oatmeal) or dry breakfast (muesli, cereal).

• Eat sea fish at least twice a week for the second.

• Use vegetable oil, preferably olive oil.

• Instead of ice cream, eat frozen kefir yogurt or juice.

• For salads, use diet dressings, diet mayonnaise.

• Instead of salt, use garlic, herbal or vegetable spices.

• Watch your weight. If you have it elevated, try to reduce it, but not more than 500-700 grams per week.

• More movement!

• Monitor your cholesterol levels.

• Only positive emotions!

Today, few people think about what heart bypass surgery after a heart attack is, how long they live after heart bypass surgery, and others. important points until the disease progresses.

Radical decision

Ischemic heart disease is one of the most common pathologies today. circulatory system. Unfortunately, the number of patients is increasing every year. As a result of coronary artery disease, due to insufficient blood supply to the heart muscle, it is damaged. Many leading cardiologists and therapists of the world tried to fight this phenomenon with the help of pills. But nevertheless, coronary artery bypass grafting (CABG) still remains, albeit radical, but the most effective way to deal with the disease, which has confirmed its safety.

Rehabilitation after CABG: the first days

After coronary artery bypass surgery, the patient is placed in the intensive care unit or intensive care unit. Usually, the action of some anesthetics continues for some time after the patient woke up from anesthesia. Therefore, it is connected to a special apparatus that helps to carry out the function of breathing.

In order to avoid uncontrolled movements that can damage the sutures on the postoperative wound, pull out catheters or drains, and disconnect the IV, the patient is fixed with special devices. Electrodes are also connected to it, which record the state of health and allow medical personnel to control the frequency and rhythm of contractions of the heart muscle.

On the first day after this heart surgery, the following manipulations are performed:

• The patient takes a blood test;
• X-ray examinations are carried out;
• Electrocardiographic studies are being performed.

Also on the first day, the breathing tube is removed, but the gastric tube and chest drains remain. The patient is now fully breathing on his own.

Tip: At this stage of recovery, it is important that the operated person is kept warm. The patient is wrapped in a warm duvet or woolen blanket, and special stockings are put on to avoid stagnation of blood in the vessels of the lower extremities.

To avoid complications, do not engage in physical activity without consulting your doctor

On the first day, the patient needs peace and care of the medical staff, who, among other things, will communicate with his relatives. The patient is just lying down. During this period, he takes antibiotics, painkillers and sedatives. Within a few days, a slightly elevated body temperature may be observed. This is considered a normal reaction of the body to surgery. In addition, there may be severe sweating.

As can be seen, after coronary artery bypass grafting, the patient needs third-party care. As for the recommended level of physical activity, it is individual in each case. At first, it is allowed to just sit and walk within the room. After some time, it is already allowed to leave the ward. And only by the time of discharge the patient can walk along the corridor for a long time.

Tip: the patient is recommended to lie down for several hours, while it is necessary to change their position, turning from side to side. Lying on your back for a long time without physical activity increases the risk of developing congestive pneumonia due to the accumulation of excess fluid in the lungs.

When using the saphenous vein of the thigh as a graft, swelling of the lower leg may be observed on the corresponding leg. This occurs even if smaller blood vessels have taken over the function of the replaced vein. This is the reason why the patient is recommended to wear support stockings made of elastic material for 4-6 weeks after the operation. In addition, in sitting position this leg needs to be slightly elevated so as not to disturb the blood circulation. After a couple of months, the swelling resolves.

In the process of recovery after surgery, patients are prohibited from lifting weights of more than 5 kg and performing strenuous exercise

The sutures from the leg are removed a week after the operation, and from the chest - immediately before discharge. Healing occurs within 90 days. For 28 days after the operation, the patient is not recommended to drive to avoid possible damage sternum. Sexual activity can be carried out if the body will take a position in which the load on the chest and shoulders is minimized. You can return to the workplace one and a half months after the operation, and if the work is sedentary, then even earlier.

In total, after coronary artery bypass grafting, rehabilitation takes up to 3 months. It includes a gradual increase in the load when performing physical exercises, which must be done three times a week for one hour. At the same time, patients receive recommendations on the lifestyle that must be followed after the operation in order to reduce the likelihood of progression of coronary heart disease. This includes smoking cessation, weight loss, special nutrition, constant monitoring of blood cholesterol and blood pressure.

Diet after CABG

Even after discharge from the hospital, while at home, it is necessary to adhere to a certain diet, which will be prescribed by the attending physician. This will significantly reduce the chances of developing heart and vascular disease. One of the main foods that should be minimized are saturated fat and salt. After all, the operation performed does not guarantee that in the future there will be no problems with the atria, ventricles, blood vessels and other components of the circulatory system. The risks of this will increase significantly if you do not adhere to a certain diet and lead a carefree lifestyle (continue to smoke, drink alcohol and do not do wellness exercises).

It is necessary to strictly follow the diet and then you will not have to face again the problems that led to the surgical intervention. There will be no problem with transplanted veins replacing the coronary arteries.

Tip: in addition to diet and gymnastics, it is necessary to monitor your own weight, the excess of which increases the load on the heart and, accordingly, increases the risk of re-disease.

Possible complications after CABG

Deep vein thrombosis

Despite the fact that this operation is successful in most cases, the following complications may occur in the recovery period:

• Thrombosis of vessels of the lower extremities, including deep veins;
• Bleeding;
• wound infection;
• The formation of a keloid scar;
• Violation of cerebral circulation;
• myocardial infarction;
• Chronic pain in the incision area;
• Atrial fibrillation;
• Osteomyelitis of the sternum;
• Seam failure.

Tip: Taking statins (cholesterol-lowering drugs) before CABG significantly reduces the risk of scattered atrial beats after surgery.

Nevertheless, one of the most serious complications is perioperative myocardial infarction. Complications after CABG may appear due to the following factors:

• Postponed acute coronary syndrome;
• Unstable hemodynamics;
• The presence of severe angina;
• Atherosclerosis of the carotid arteries;
• Left ventricular dysfunction.

The risk of complications in postoperative period women, the elderly, diabetics, and patients with renal insufficiency are most affected. Careful examination of the atria, ventricles and other parts of the most important human organ before surgery will also help reduce the risk of complications after CABG.

Rehabilitation after coronary artery bypass surgery

Cardiorehabilitation methods after CABG

CARDIOLOGY - prevention and treatment of HEART DISEASES - HEART.su

The Argentinean René Favaloro is credited with pioneering the bypass technique, who pioneered the method in the late 1960s.

Indications for coronary bypass surgery include: