Coronary artery bypass grafting: patient reviews, complications. Rehabilitation after cardiac bypass surgery. How long and how do people live after heart bypass surgery

Surgical shunting of the heart vessels provides blood flow to the myocardium by creating anastomoses - artificial blood supply pathways from the patient's donor material. This method allows you to resume the supply of oxygen to the heart, disrupted due to a decrease in the lumen of the coronary vessels.

Indications for the operation

Coronary artery bypass grafting is performed with the following pathological changes:

blockage of the coronary artery of the left section;
obstruction of the coronary arteries approaches 70% or exceeds this value;
stenosis of more than two coronary arteries, accompanied by acute attacks of angina pectoris.

Clinical indications:

angina pectoris of the third and fourth functional class, unresponsive to conservative treatment;
acute coronary syndrome with a threat of myocardial infarction;
myocardial infarction in an acute form no later than 6 hours after the development of intractable pain syndrome;
ischemia not aggravated by pain syndrome, established as a result of daily monitoring of blood pressure and ECG according to Holter;
reduced exercise tolerance, established as a result of tests on the treadmill test and bicycle ergometry;
heart disease complicated by myocardial ischemia.

The reason for the appointment of CABG are situations in which percutaneous access is impossible, and angioplasty and stenting do not bring results.

Heart surgery is prescribed by a doctor only after the complex condition of the patient, in which the degree of organ damage, chronic diseases, possible risks, etc. are established. Be sure to take into account the patient's condition at the time of determining the need for surgical intervention.

Contraindications

The following conditions can become an obstacle to shunting:

How is ACS performed?

The essence of the method lies in the fact that thanks to the shunt, a bypass is created that provides free blood flow from the aorta to the artery, bypassing the clogged part. For this purpose, donor material of the patient himself is used: the thoracic artery, the radial artery or the great saphenous femoral vein. The best option is the thoracic artery, since it is minimally susceptible to atherosclerosis.

Shunting can be single or multiple, based on the number of obstructed coronary vessels.

ATTENTION! There are alternative ways to correct the condition of clogged vessels. These include medical therapy, coronary angioplasty, and stenting.

Preparing for the operation

Preparation for the operation depends on the urgency of its appointment, that is, on whether it is planned or emergency). After myocardial infarction, urgent coronary angiography is performed, if necessary, expanding it to stenting or CABG. In this case, they are limited to the minimum necessary tests: determination of the blood group, clotting factors and ECG in dynamics.

If the operation is prepared in a planned manner, then the patient is sent for a comprehensive examination:

Ultrasound of the heart;
general analysis of blood and urine;
chest x-ray;
coronary angiography;
hepatitis and HIV markers;
Wasserman reaction;
coagulogram.

Most tests are done on an outpatient basis. The patient is admitted to the hospital one week before the operation. From this moment on, the preparation for the operation is supervised by doctors, also teaching the patient a special breathing technique that will come in handy after surgery.

Extreme food intake is allowed the day before surgery. Drinking liquid later than the day before the procedure is also prohibited. After the last meal, the patient takes the last dose of drugs. In the morning before the operation, the patient is given a cleansing enema, washed, and also shaved the chest and that part of the body from which the grafts for shunts will be excised.

ATTENTION! The preparatory stage also includes the signing of documents.

Operation progress

The operation is performed under general anesthesia. The duration of the procedure varies from 3 to 6 hours. It depends on the complexity of each case and the number of shunts supplied. Access to the heart is obtained as a result of sternotomy - dissection of the sternum or through a mini-incision in the intercostal cavity of the left projection of the heart.

After the shunts are placed, the breast bones are fixed with metal staples, and the tissues are sutured. Bloody discharge from the pericardial cavity is removed through the drainage system.

There are three types of ACS:

With the connection of the patient to the cardiopulmonary bypass machine and controlled cardiac arrest of the patient, they operate on an open heart.
Not connected to a heart-lung machine. This method reduces the risk of postoperative complications and reduces the time of the operation. But at the same time, technically, such open-heart surgery is much more complicated.
With the help of minimally invasive access - without or connected to the AIC. The method appeared recently and is used only in some clinics. It has advantages in the form of a minimal risk of complications and a short rehabilitation period.

Possible Complications of CABG

Complications of CABG are divided into specific and non-specific. Non-specific risks include the risks associated with any operation.

Specific complications include:

heart attack;
inflammatory process of the outer leaf of the pericardial sac;
malfunctions of the myocardium and tissue starvation as a result of insufficient blood supply;
arrhythmias of various forms;
infectious lesions of the pleura and trauma;
stroke.

Rehabilitation in the postoperative period

Rehabilitation takes place in several stages. Ten days after shunting, the suture is tightened, and six months later, the bone frame of the sternum heals.

At the first stage of postoperative rehabilitation, the patient must adhere to a diet, regularly perform breathing exercises - to avoid stagnation of blood in the lungs, and practice moderate physical exercises - lying down and walking.

Do exercise therapy and take medicines prescribed by your doctor.

After discharge, the patient must perform therapeutic physical exercises to strengthen the cardiovascular system.

Subject to compliance with medical prescriptions, the prognosis after surgery is positive. Lethal cases do not exceed 5% of the total number of operations. On average, if CABG is successful, patients live more than ten years after surgery.

Coronary artery bypass grafting for heart attack, coronary heart disease is the only reliable way to treat the final stages of the disease and its acute manifestations. With the help of modern technologies, such an operation continues the patient's life for decades.

Indications

Cholesterol, accumulating in the tissues of the body, is deposited in the heart vessels and clogs them. This is the cause of atherosclerosis of the coronary arteries, which leads to coronary heart disease.

Cardiac tissues are supplied with food and oxygen by the coronary vessels. It is inside them that cholesterol is deposited in the form of plaques that form blood clots. With the development of the disease, the throughput decreases, the lumen inside the vessels becomes thinner.
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A neglected disease, untimely adoption of the necessary therapeutic measures threaten with serious consequences up to myocardial infarction and. Causes the most serious consequences.

If the blood flow and nutrition of the heart muscle is disturbed, an insufficient volume of blood enters it, anomalies in its functioning occur, and with a significant vasoconstriction, death of heart cells occurs.

With vascular thrombosis in a patient with a mild form of the disease and in its initial stages, pain occurs in the thoracic segment - symptoms. It is especially evident during physical stress.

The worst case is a heart attack - the death of an accumulation of myocardial cells, which threatens the patient with death. The situation will be corrected by shunting in case of a heart attack.

Therapeutic therapy for ischemia is aimed at eliminating these consequences.

The following methods are used for this:

Indications for the operation:

critical narrowing of the left artery;
thrombosis of all or part of the coronary arteries;
myocardial infarction.

CABG can completely eliminate the symptoms of the disease. This is the most effective, albeit radical, method of treatment.

How do they do

Cardiac bypass surgery is effective in the vast majority of cases: when one or all vessels malfunction.

Briefly, what is heart bypass surgery after a heart attack: suturing of vessels taken from the patient's body, acting as new pathways for feeding heart tissue, parallel to arteries with impaired functionality. New channels of nutrition of cardiac tissues are called "shunts".

The principle of the operation is to direct blood flow along new pathways-vessels that bypass blocked segments or areas of stenosis. This is achieved by suturing one end of the vein to the aortic and the other to the arterial opening.

Shunts are created from segments of the functional vessels of the patient's body. Usually they are taken from the limbs, as there are veins and arteries with considerable length. An artery located in the chest is also used. Its peculiarity is that it already has a connection with the aorta, the surgeon only needs to connect its end to the cardiac artery.

The tasks of CABG: the resumption of normal blood flow, the establishment of healthy nutrition of the myocardium.

Kinds

Depending on the complexity of the pathology, on how many vessels of the patient blockages have formed, several types of operations are distinguished.

Shunting for a heart attack has the following types, depending on the number of treated vessels:

single;
double;
triple or more.

Each affected vessel is duplicated by its own separate shunt. The state of the body is not a determinant of the number of shunts to be implanted: with severe forms of coronary artery disease, a single bypass can be done, and for an unexpressed degree of the disease, triple manipulation is sometimes required.

Varieties of CABG, depending on the work of the heart in its process:

Training

Before the operation, a complete examination of the patient's body is carried out:

All standard tests, studies (complete blood, urine, etc.), as well as additional ones prescribed by a doctor.
Complete examination of the cardiac (ultrasound, ECG), circulatory system.
Detailed assessment of the patient's condition.
Angiography (coronography). Its task is to determine which vessels are clogged, the size of the plaques. The procedure is carried out using an x-ray machine, a contrast agent is injected into the arteries, visible on x-rays.

Some of the studies are done on an outpatient basis, some are inpatient. The patient enters the hospital 7 days before the procedure, where the main preparatory actions are carried out for it. The patient is taught special breathing techniques, they need to be applied in the postoperative period.

Rehabilitation

The operated person, in addition to what is heart bypass surgery after a heart attack, needs to know about the importance of rehabilitation therapy. This is the first priority after the USC.

Immediately after surgery, the operated person is transferred to the intensive care unit. The functions of the lungs and myocardium are restored there. The person undergoing surgery needs to resume proper breathing. The period of stay in intensive care is up to 10 days.

After the end of the primary rehabilitation in the hospital, rehabilitation therapy continues in the special conditions of the rehabilitation center.

During the rehabilitation period of wound healing, the patient is prescribed to wear elastic bandages or stockings on the limbs. This will help eliminate venous congestion, vascular thrombosis. A bandage or corset is applied to the chest area. During the recovery period, strong physical exertion is prohibited.

Changing body positions at the correct intensity allows you to speed up the rehabilitation process. The doctor should acquaint the patient with how to lie correctly, transfer the weight of the body to the side.

Rehabilitation measures are considered completed upon successful completion of the stress test. It is carried out 2–3 months after surgery, on the basis of which the functionality of the transplanted bypasses, the quality of blood flow, and the level of oxygen supply to the heart tissues are evaluated. The test is considered passed if there is no pain, ECG changes.

Seam tightening

There are sutures on the patient's body in two places:

where the shunt material was taken for transplantation (on the limbs);
on the chest, at the site of the bypass.

To tighten the seams, the usual procedures in such cases are used:

dressings;
regular washing with antiseptics.

The task of the procedures is to avoid suppuration.

With normal, normal wound healing, the sutures are removed after a week. Burning, as well as moderate pain in the places of incisions, indicate a normal healing process, they disappear after a while. Usually after 7-14 days, when the wounds heal more strongly, the patient can take a shower.

Bones of the sternum

The healing period of the sternum bones is 4-6 months. This area requires rest for recovery: sudden movements, physical exertion on the chest area interfere with healing.

The necessary conditions help to provide special chest bandages, which are applied in a special way. The doctor may also consider it necessary to prescribe the wearing of a special corset.

Breath stabilization

Breathing is given special attention, as it is associated with the work of the heart. After the operation, this function needs to be restored, because the body "forgets" how to breathe properly.

Particular attention should be paid to pneumonia, inflammatory processes of the respiratory tract, lung diseases.

Almost immediately after the operation, the patient should apply the breathing exercises that he was taught during the preparatory period.

Coughing is a common occurrence after surgery, this is normal and the patient does not need to be afraid of this symptom. To facilitate coughing, it is recommended to press your palms or a ball to your chest.

Physical exercise

The rehabilitation period is accompanied by gradually increasing physical activity. Symptoms of angina pectoris, pain in the thoracic region, respiratory disorders should disappear with time.

As the patient recovers, gradually increasing motor activity is prescribed, and over time, physical exercises are increased until the body is fully restored.

The restoration of physical activity begins with walking along the corridors of the hospital or nearby territory at a distance of up to 1 km per day with a small rhythm of steps.

Loads gradually gain intensity, and after a certain period of time, the restrictions imposed on the mode of physical activity are removed in full.

Sanatoriums

The operated person will be able to engage in a full-fledged labor activity one and a half to two months after the surgical intervention.

Possible Complications

An infarction of the anterior wall of the heart or its posterior wall, together with subsequent CABG, greatly weakens the body.

Due to blood loss during surgery, short-term anemia may occur. It disappears over time - it is enough to provide the convalescent with nutrition with the necessary amount of iron and vitamins.

Complications occur infrequently, these are, for the most part, swelling or inflammation. Less often - bleeding from a wound, infectious complications.

Symptoms of inflammation: fever, joint aches, pain in the chest segment, weakness, abnormal heart rhythm. The provoking factor of inflammatory phenomena is the body's autoimmune reactions to engraftment of its own tissues.

In isolated cases, the following complications are observed: stroke, thrombosis, malunion of the bone tissues of the sternum, infarction, amnesia, keloid scar tissue, kidney disease, postperfusion syndrome, pain effects at the site of surgery.

Their occurrence depends on the preoperative state of the operated. It is important for the surgeon to analyze the general condition of his body in order to determine and predict the possible consequences of the intervention.

The risk of complications is increased by the following factors:

smoking;
excess weight;
hypodynamia;
high blood pressure;
kidney disease;
diabetes;
the body's tendency to accumulate cholesterol.

The patient's behavior - non-compliance with prescriptions, termination of recommended procedures, diet violations, heavy loads, etc. - can itself become the cause of negative phenomena.

Separately, it should be said about relapses. In an organism prone to accumulation of cholesterol, the formation of new plaques continues, blockages of already new bypass vessels (restenosis) are created, then stenting of these vessels is done - a new operation is not required. To exclude relapses, it is important to follow a diet, limit salt, fats, and sugar in the diet.

Results of heart bypass surgery after a heart attack

Successful shunting after a heart attack suggests the following consequences:

normalization of cardiac blood flow and myocardial nutrition;
disappearance of angina attacks;
reduction ;
ability to work is restored;
improves well-being;
the degree rises;
life expectancy increases, the risk of sudden death decreases;
drug therapy is stopped, except for the prophylactic minimum of drugs.

After CABG, the patient leads normal, full-fledged activities, with the exception that it is necessary to adhere to a diet and a healthy lifestyle in order to avoid relapses. The first requirements for excluding the recurrence of coronary disease are to forget about and.

Almost all symptoms of the disease disappear in 70% of those who underwent surgery, in 85% of cases, re-occlusion of blood vessels does not occur in those who underwent surgery, the condition of a third of patients improves immediately. The average service life of a shunt is 10 years (more in young patients), after its expiration, a second operation is required.

Price

The cost of coronary artery bypass grafting, given the complexity of the operation, is quite high.

The price is determined by several factors: the complexity, the number of shunts, the use of high-quality medicines and equipment, the patient's condition, rehabilitation measures, the necessary additional preparatory actions, the conditions of the clinic, and the level of its prestige.

In Moscow clinics, the price of the operation ranges from 150 thousand to 500 thousand rubles. The higher the price, the more prestigious the clinic. In Israel, Germany, such an operation will have to pay from 800 thousand to one and a half million rubles.

The process of shunting is to create a shunt, which bypasses the narrowed portion of the blood vessel. Due to this, blood flow is restored in the affected area of the artery.

The normal inner wall is smooth and even. But with the development of atherosclerosis, atherosclerotic plaques form on the walls of blood vessels. Because of them, there is a narrowing of the lumen of the vessels, and this leads to a deterioration in blood flow in organs and tissues. After some time, the lumen completely disappears and completely closes - this already leads to the cessation of blood flow. This is followed by necrosis.

Most often, the bypass process is used for coronary heart disease, since with it the coronary arteries (main vessels) that feed the heart are affected. The bypass process is also used to restore blood flow in the peripheral arteries.

Preparatory measures for bypass surgery

Before starting the operation, the surgeon carries out a detailed survey of the patient, finds out the complaints, what they are, at what point they were formed, what caused them, and so on. Next, the doctor conducts a visual examination. Then the pulsation of the arteries is felt. A very important preparatory stage is the stage of specialized research methods.

Here are the methods:

Duplex ultrasonic scanning- it allows you to visually see what kind of lumen the blood vessels have, whether there are plaques, blockage, and also determine the speed of blood flow in the vessels.
Magnetic resonance angiography- this study allows you to view the lumen of the vessels "in layers".
Angiography- a method of x-ray contrast study of blood vessels, thanks to it you can see how much vasoconstriction has occurred, see the place where the blockage has occurred, and it can also be used with medical procedures - angioplasty.

If there are problems with cardiac activity, then ultrasound of the heart, as well as coronary angiography and other related studies, are performed.

Indications for vascular bypass

If there are symptoms of atherosclerosis, namely cardiac ischemia, obliterating atherosclerosis, peripheral artery aneurysm, and so on, that is, most likely, such problems can be prescribed. This operation is also prescribed when there are contraindications to angioplasty and stenting.

Risks of complications during vascular bypass surgery

Here are the points that can increase the risk of complications during the operation:

High blood pressure
Overweight
Elevated cholesterol
coronary heart disease
(emphysema, bronchitis, etc.)
kidney failure
High blood sugar -
Bad habits - smoking, alcohol abuse
Sedentary lifestyle

Most often, this operation takes place either under general anesthesia or under local anesthesia. If shunting occurs on the arms or legs, then the saphenous vein of the thigh is most often used as a shunt. The removal of this vein from the thigh practically does not affect the blood flow in the lower limb in any way. The question arises: why are leg veins taken during shunting? Because they are usually practically healthy, i.e. not affected by atherosclerosis. Also, these veins are longer and larger than others that can be used in the same way. It also happens that instead of a vein, another vein is used as a shunt, or a shunt made from a synthetic material.

At coronary artery bypass grafting(a bypass technique used for coronary heart disease) arteries are used as a bypass. In this case, the internal thoracic and radial arteries are often used and preferred for shunting. Thanks to this, the shunt functions more fully.

One of these arteries is the radial artery of the hand, it is located on the inner surface of the forearm closer to the thumb. If it is necessary to use this artery, the doctor will carry out additional studies that will help to exclude the occurrence of any complications that may appear with the sampling of this artery. Therefore, one of the incisions will be on the arm, most often on the left.

The surgeon makes an incision in the area of the affected vessel. Further, he allocates the affected vessel, where it is necessary to suture the shunt, and small incisions are made. Then the shunt is sutured with the ends to the affected vessel. Due to this, the blood flow of the vessel is restored. After the operation is completed, specialized research methods are carried out:

angiography,
duplex ultrasound scan.

Thanks to these studies, the doctor is convinced that the process of installing the shunt was correct.

Coronary artery bypass grafting

Coronary artery bypass grafting is of the following varieties:

With the use of artificial circulation.
Without cardiopulmonary bypass - a "stabilizer" is used to bypass blood vessels.
The use of minimal surgical incisions, including endoscopic operations.

The period of postoperative recovery after vascular bypass surgery

Usually, after the operation, the patient remains in the hospital for 3 to 20 days under observation. The stitches are removed on the seventh day after the operation.

The number and length of incisions on the legs in different patients may be different - it depends on the number of venous bypasses that have been installed. There are patients who will have incisions on only one leg, and there are those who have incisions on both legs, and there are also those who have incisions on their arm.

First, the sutures are washed with an antiseptic, then the dressing is done. After that, on the 8-9th day, with successful healing, the sutures will be removed, and the safety electrode will also be removed.

Then it will be possible to wash the seams with soap and water. After this operation, swelling of the ankle joints may develop or there will be an unpleasant burning sensation in the places where the veins were removed. It will be felt while standing or at night. After some time, in the process of restoring blood circulation in the places where the veins were taken, these unpleasant sensations will disappear.

Postoperative complications

Of course, as with other operations, complications are possible after bypass surgery, although they are not common. Most often, these are swelling, as well as inflammation in the area of the incisions. Less commonly, there are bleeding from wounds, as well as a recurrence of blockage of blood vessels and a shunt.

Video about vascular bypass

Shunting is an extremely complex operation that is performed on the vessels. Its purpose is to normalize and restore blood circulation throughout the body, as well as each individual organ.

The bypass procedure is always associated with certain risks, although in most cases it is this operation that allows you to return a person to life. Until recently, it was available only to patients with great financial resources. Everyone else had to be content with only vague hopes. At the moment, the picture is already completely different, but many still do not even know what heart bypass surgery is.

Show all
The essence of the operation
Shunting artificially creates a new pathway for blood flow. If you understand how to do shunting, then first of all it should be noted that it is carried out using a vascular shunt. His surgeons are looking for the patient himself in the internal mammary artery, whose health requires surgical intervention. For similar purposes, doctors can use the radial arteries of the hands, or the large veins of the legs.
Indications for carrying out
The main indication for shunting is usually the presence of coronary heart disease - a chronic disease, the final stage of which can be myocardial infarction. Ischemia is associated with damage to the coronary arteries responsible for the nutrition of the heart muscle. It is in these arteries that cholesterol is deposited. At a certain stage, these deposits lead to a narrowing of the lumen inside the vessel, and, as a result, a deterioration in the access of blood to the heart muscle, as well as a subsequent oxygen deficiency.
According to patients, chronic coronary heart disease is often associated with pain behind the sternum, next to the heart muscle. In advanced cases, there is a possibility of tissue necrosis and the muscle itself. In this case, angina ("angina pectoris") is usually put as a diagnosis. The work of the heart in conditions of affected blood vessels leads to the fact that it wears out very quickly and may need to be renewed.
Coronary artery bypass grafting of the heart vessels, carried out on the recommendation of doctors, usually helps to bring the body back to normal. To ensure moral readiness for the upcoming operation, the patient should talk with their loved ones, feel their support, and also talk in detail with their doctor.
intervention in atherosclerosis
According to most experts, the use of surgery is an extreme measure that can be used only when all other methods of treatment can no longer have the desired effect. These cases include ischemic or coronary heart disease (CHD), as well as atherosclerosis, which has similar symptoms.
In the formation of atherosclerosis, cholesterol is also of particular importance, but in this case, the deposits of this compound do not just narrow the vessels, but completely block them. Therefore, the likelihood of coronary heart disease, or atherosclerosis, directly depends on the amount of cholesterol accumulated inside the body. Excessive amount of it with a probability of 100% will cause narrowing and blocking of the vessels of the heart. As a result, oxygen does not enter the heart (or does, but very poorly) and myocardial hypoxia is formed.
Types of heart bypass surgery
Conventionally, there are three options for aortocoronary bypass grafting (CABG):
1. 1. single;
2. 2. double;
3. 3. triple.
With this or that type of operation, the choice made is determined only by the extent of the vascular lesion: if only one artery does not function and only one shunt is required, then this is a single type bypass, two arteries are blocked - double, and three - respectively triple heart bypass.
Preparatory stage
On the eve of surgery, the patient is sent for coronary angiography (a method for checking the condition of the coronary vessels of the heart). In addition, you will need to pass some tests, undergo an ECG and ultrasound.
The preparation period for the operation begins 1.5 weeks before the day when the bypass surgery is scheduled. In parallel with the delivery of tests and the passage of various studies, the patient masters the special breathing technique necessary for recovery in the postoperative period.
Operation duration
The duration of a heart bypass operation may vary depending on the condition of the patient and how difficult the surgery will be. In most cases, the patient is given general anesthesia, and he is on the operating table for 3-6 hours.
The shunting process is very time consuming and extremely exhausting. For this reason, one team of specialists is allowed to perform only one such operation per day. Life expectancy after bypass surgery depends on the experience of the surgeon, how well the CABG was performed, and the body's own ability to recover.
Postoperative period
When the operation is over, the patient is usually taken to the intensive care unit, where he will need to undergo a short course of procedures related to restorative breathing exercises, which he mastered even before the bypass.
Taking into account certain individual moments, the patient may not leave the intensive care unit for up to 10 days after heart surgery. After the operation, the patient is given a referral to stay in a special rehabilitation center for the purpose of subsequent final recovery.
All this time, the seams are regularly treated with antiseptics. This is usually accompanied by burning and pulling pain. If the healing process is successful, then the stitches are removed after a maximum of a week. All adverse symptoms disappear within five days, and after one or two weeks, the operated person is already able to take a shower on his own.
Forecast of a successful outcome
Accurate information about how many bypass surgeries ended successfully, as well as how many people returned to normal life after that, or even managed to radically change it, can be obtained from statistical data. In addition, there are numerous results of studies and sociological surveys on this topic, the authors of which are both domestic and foreign experts.
According to studies on CABG, the probability of death is only 2% of the total numbersick. These results were obtained through the analysis of case histories of more than, than 60 thousand examined.
According to statistics, the most difficult stage on the road to recovery is the postoperative phase. After updating the respiratory system, 97% of those operated on live for at least a year. Those who survived these 12 months are no longer in danger of dying from the consequences of surgery.
The favorable outcome is determined by how the patient tolerates a particular type of anesthesia, how strong the defenses of his body are and whether he has pathologies or diseases of other organs and systems.
Another study conducted by experts on the basis of data reflected in the medical records of more than a thousand people. The results of this testing showed that approximately 20% of the subjects not only did not experience any complications and problems, but were able to live to their ninetieth birthday.
Lifespan
In most cases, heart bypass surgery after a heart attack "gives" a patient suffering from coronary heart disease at least a few more years of life. Despite widespread beliefs, the shunt installed by the surgeon will not clog even after 10-15 years of life, these are the data of Israeli doctors.
However, despite the high likelihood of success, you should not rush right off the bat and insist on the operation without consulting with a specialist and without reading the reviews of those who have already had experience of going through this procedure.
It happens that operated patients note a general relief of the condition: the breathing process is simplified, pain in the chest area disappears. In this case, one can judge the extraordinary effectiveness of the operation. Sometimes, relatives of the patient note that recovery from anesthesia and other procedures can take a long time. There are also reviews previously about operated people who have been living for ten years and do not have any complications, especially since they have not had cases of recurrence of heart attacks.
Expert opinions
Cardiac surgeons believe that a person who has undergone heart bypass surgery can live up to 20 years after the operation, of course, if at the same time he does not treat his health too dismissively. In addition, it is recommended to visit the attending physician and cardiologist with a certain regularity, undergo examinations, monitor the condition of the implants, adhere to the prescribed diet and devote time to physical activity.
In most cases, doctors refer not only elderly people to surgery, but also younger patients if they have a heart disease. According to them, surgery is tolerated by young people much easier, and the rehabilitation process takes much less time. However, this is not a reason to be afraid of the bypass procedure if you have already reached a more mature age, especially since it will increase life expectancy by a decade and a half.

Popular questions
The duration of the shunt: Each medical institution has its own data on this. As a result, data from Israeli cardiac surgeons suggests that a shunt can remain in working order for more than a decade. However, venous substitutes serve much less.
- What is a shunt: The term "shunt" refers to a part of a vein used as an alternative branch for blood flow, allowing blood to flow around the affected and blocked artery. At a certain moment, the vessel walls are deformed, some areas expand, and in these areas an accumulation of thrombi of atherosclerotic plaques is formed. An arterial shunt allows you to bypass these accumulations.
- Is it possible to perform cardiac catheterization after bypass surgery? A: Yes, this is perfectly acceptable. In this case, the blood supply is restored, even if the patient's coronary disorders are quite complex. In this case, the bypass procedure is performed in such a way that the coronary artery is not affected. Special centers provide services for balloon angioplasty of other arteries or bypasses.
- Does pain in the heart after surgery mean that it was unsuccessful: If the patient feels heart pain after recovering from surgery or in the later stages of recovery, then he should seek the advice of a cardiac surgeon so that he can assess the likelihood of blockage of the shunt. If the suspicion of this problem is confirmed, then urgent measures will need to be taken, or the patient will soon feel the first symptoms of angina pectoris.
- Should Medications Be Taken Long After Bypass Surgery?: surgery for heart bypass is such an event in which there is no cure for concomitant diseases. Medications are required. They will stabilize blood pressure, maintain a certain level of glucose in the bloodstream, regulate cholesterol, triglyceride.

Shunting is called surgical intervention, during which a new path for blood circulation is created in order to bypass the damaged area of the vessel, for this purpose special shunts are inserted.

If you make a literal translation of the English word "shunt", you get a "branch". This method is used mainly on the heart, however, it can be done on the brain, with excess weight - on the gastrointestinal tract.

Damage to the walls of blood vessels occurs due to cholesterol plaques that accumulate on them throughout life. Thus, the lumen of the vessel is blocked, preventing the blood flow from functioning normally.

The heart receives nutrients and oxygen from the blood that moves through the coronary arteries, if they are blocked, it is necessary to perform coronary artery bypass grafting or CABG for short.

Bypass surgery is performed after a heart attack, diagnosed angina pectoris, or as a prevention of a heart attack if the blood vessels are too narrowed. As already mentioned, a shunt is an artificially created vessel that will help blood flow to bypass the damaged area. For a shunt, a small section of a healthy artery is taken, it can be the saphenous vein of the lower leg, thigh, or radial vein. It can be taken from the patient himself. Sometimes plastic prostheses act as a shunt. For example, if you need not one shunt, but many.

If in stressful situations, physical exertion, and even at rest, pain began to appear, an examination should be carried out. After all, these are the first signs of impaired functioning of the heart.

Indications for shunting

Shunting can be performed according to the main indications or according to the patient's condition, if this method is recommended to him by a specialist.

In medical practice, there are three main indications for such an operation:

Left artery, fifty percent damaged.
The diameter of all blood vessels is less than thirty percent.
With a severely damaged anterior interventricular artery, at its beginning.

Bypassing the heart after a heart attack helps to eliminate ischemia, so blood flow is restored, and the risk of relapses is reduced.

Contraindications for this procedure

Just like any other operation, shunting has its contraindications, and they are as follows:

A lot of blood vessels are affected, while the area of damage is versatile.
A sharp failure in the left ventricle, when the ejection function from it is less than thirty percent.
Failures in the work of the heart, when it cannot pump the necessary amount of blood.

In addition to individual contraindications, there are also general ones, for example, diseases that develop in parallel with a heart attack, chronic lung diseases, and cancerous pathologies. However, each patient is considered on an individual basis.

And as for the elderly, this is most likely a risk factor during the operation itself, and not a contraindication to it.

Preparation for bypass surgery

After the patient is taken to the clinic, he signs certain documents and gives his consent (on paper) for the doctors to conduct the necessary studies and the operation itself.

As an examination, electrocardiography, various tests, a contrast x-ray of the coronary vessels are performed (this will make it possible to establish the area of damage to the vessel). The patient is told the essence of the intervention and how to breathe.

In addition, there are other important points:

The day before the surgery, the person should eat and drink, this will be the last time before the surgery.
The areas where the incision will be made for surgery and vein harvesting for the bypass must be shaved.
On the eve of the evening and in the morning, the intestines should be freed from food debris, and immediately before the operation, take a shower.
Medicines should also be taken after the last meal.
The day before the operation, the doctor who will operate and the staff helping him make a plan for the surgical intervention.

How is the operation itself

To date, there are several methods of shunting:

With the help of artificial blood flow.
Without artificial blood flow, but with the use of a "stabilizer" for shunting.
Endoscopic operations, that is, mini instruments are used for this, for which it is necessary to make only small incisions or punctures. Thanks to this method, the patient loses less blood, experiences less pain and discomfort immediately after the intervention.

The first method is usually used, for this patient is introduced into general anesthesia. The sternum is opened, the heart is stopped and the patient is transferred to an artificial blood flow apparatus. This means that the patient's blood is now passed through the apparatus, saturated with oxygen there and returned to the patient's body again.

The surgeon first removes the graft (vein from the patient's body) and sews it into the blood vessel in such a way as to bypass the affected (blocked) area. The entire procedure takes three to six hours.

But in recent times, surgeons often practice bypass surgery on a beating heart without connecting an artificial blood flow machine. But this requires another device that will help reduce the heart rate.

Such operations have their own advantages, for example:

After them, there are practically no complications.
The patient loses less blood.
Rapid patient recovery.

What happens after the operation

After the surgical intervention is completed, the patient is disconnected from all devices that are in the operating room and taken to the intensive care unit. The patient will stay there for some time, it all depends on the operation and its complexity. All this time, medical personnel, in particular a nurse, will be nearby.

Her duties include: monitor the vital functions of the patient's body, administer medications, take the necessary tests, conduct research and make dressings. After a certain time, the patient is transferred to another ward, where his condition will be monitored around the clock.

For the first time after the operation, the patient must be in special elastic stockings or bandages. This will prevent swelling of the legs. Gradually, depending on the condition of the patient, he is allowed small physical exertion. The doctor also prescribes a special diet. It is necessary to strictly follow all the recommendations of the doctor so that the rehabilitation period passes quickly and without complications, and the person returns to his usual life.

When the general condition of a person is stabilized, he is discharged and it is recommended to carry out further rehabilitation at home. The most suitable option is to go on vacation to a sanatorium or to a specially designed rehabilitation center.

Positive aspects of shunting

We have already figured out what a heart bypass performed immediately after a heart attack is. However, it should be said that along with this method, stenting is also used. In medical practice, there are no main reasons why one or another method is chosen for the operation.

But doctors can only say one thing - shunting is most effective if:

There are contraindications to stenting, and the patient has a severe form of angina pectoris, which does not allow him to live normally.
Several blood vessels are affected at the same time.
Due to atherosclerotic plaques, an aneurysm of the heart develops.

The results of the operation

If the bypass performed during a heart attack was successful, then this can be recognized by the following consequences:

The blood circulation of the heart is normalized, respectively, it will receive oxygen and nutrients in the required amount.
The angina attacks will stop appearing.
The risk of a heart attack will decrease.
The working capacity of a person will be restored.
Feeling better.
Increased physical activity.
The risk of death is reduced and life expectancy is increased.
Treatment with drugs is canceled, it remains only to take medications as a preventive measure.

After bypass surgery, a person leads a normal life, in addition to the fact that he should eat right, avoid stressful situations and permanently get rid of bad habits. It is the latter that is considered the main requirement to exclude relapse.

The body of each person is individual, so the conditions after surgery are different for everyone.

Speaking of a shunt, its service life is approximately ten years, if the patient is young, then more. After the expiration of this period, a second operation should be performed.

Complications

Many patients often ask the same question: “Are complications possible after surgery?” The answer is that in some cases complications may occur, and they manifest themselves as follows:

High temperature.
Rapid pulse and rapid heartbeat.
Pain in the chest or joints.
Lethargy and weakness in the body.
The occurrence of an infectious disease.
Open bleeding.
Inflammation and accumulated fluid.
Inflammation of the lungs.

Some experts suggest that this is how the body reacts to the inserted shunt.

So that pathologies do not begin to develop in the lungs, it is recommended that he inflate a balloon up to twenty times a day, so that the lungs will expand and be ventilated.

Bypass surgery is a very important procedure for a sick person, because it can prolong his life. However, it cannot cope with the reason that led the body to such a decision.

The condition of the patient after the operation largely depends on him. Therefore, it is necessary to strictly follow all the advice that the doctor gives him.

As already mentioned, it is necessary to quit smoking and drinking alcohol, balance the daily diet, lead a healthy lifestyle, do physical exercises, take medicines prescribed by a doctor.

In addition, you need to monitor your weight and check your blood for cholesterol levels.

After the patient is discharged from the hospital, he will still feel weak and “broken” for some time. To eliminate this, you need to do physical exercises. But it is worth remembering that the sternum will grow together after the operation for a long time, so you should not give a big load on it. Do not avoid walking in the fresh air, but it is necessary to monitor your pulse.

Take only those medications prescribed by the doctor, do not add or remove anything yourself. If any adverse symptoms appear, you should consult a specialist.