Heart bypass surgery in Iran (Coronary bypass surgery) is a procedure that restores blood flow to your heart muscle by diverting the flow of blood around a section of a blocked artery in your heart. Coronary bypass surgery uses a healthy blood vessel taken from your leg, arm, chest or abdomen and connects it to the other arteries in your heart so that blood is bypassed around the diseased or blocked area. After a coronary bypass surgery, blood flow to your heart is improved. Coronary bypass surgery is just one option to treat heart disease.
Coronary bypass surgery improves symptoms, such as chest pain and shortness of breath due to poor blood flow to the heart. In some situations, coronary bypass surgery may improve your heart function and reduce your risk of dying of heart disease.
When a material in your blood called plaque builds up on your arterial walls, less blood flows to the heart muscle. This type of coronary artery disease (CAD) is known as atherosclerosis.
The heart is more likely to become exhausted and fail if it’s not receiving enough blood. Atherosclerosis can affect any arteries in the body.
Your doctor may recommend heart bypass surgery if your coronary arteries become so narrowed or blocked that you run a high risk of a heart attack.
Your doctor will also recommend bypass surgery when the blockage is too severe to manage with medication or other treatments.
Because coronary bypass surgery is an open-heart surgery, you may have complications during or following your procedure. The most common complications of coronary bypass surgery are:
Heart rhythm irregularities (arrhythmias)
Less common complications include:
Infections of the chest wound
Memory loss or troubles with thinking clearly, which often improve within six to 12 months
Heart attack, if a blood clot breaks loose soon after surgery
Your risk of developing these complications depends on your health before the surgery. Talk to your doctor to get a better idea of the likelihood of experiencing these risks.
If you're having a scheduled coronary bypass surgery, your risk of complications is usually low, but still depends on your overall health. The risk is higher if the operation is done as an emergency or if you have other medical conditions, such as emphysema, kidney disease, diabetes or blocked arteries in your legs (peripheral artery disease, or PAD).
To prepare for coronary bypass surgery, your doctor will give you specific instructions about any activity restrictions and changes in your diet or medications you should follow before surgery. You'll need several pre-surgical tests, often including chest X-rays, blood tests, an electrocardiogram and a coronary angiogram. A coronary angiogram is a special type of X-ray procedure that uses dye to visualize the arteries that feed your heart. Most people are admitted to the hospital the morning of the surgery. Coronary bypass surgery may also be performed in emergency situations, such as after a heart attack.
Be sure to make arrangements for the weeks following your surgery. It will take about four to six weeks for you to recover to the point where you can resume driving, return to work and perform daily chores.
You will have general anesthesia for the surgery.
The first step in the surgery is for the surgeon to prepare the arteries or remove the veins that will be used as bypass grafts.
Next, the surgeon makes an incision down the center of your chest, through your sternum (breast bone), so your heart and coronary arteries can be seen. Your heart will likely be stopped for a short time so the surgeon can perform the bypass procedure on a “still” heart. During this time, the heart-lung bypass machine takes over for the heart and lungs, so blood keeps moving throughout the rest of the body. This is called “on-pump” surgery. The pump is turned off after the grafts are in place. Your heart beat and blood flow return to normal.
The surgery can sometimes be done without using the heart-lung machine, while your heart is still beating. This is called “off-pump” or “beating heart” surgery.
The bypass grafts are put in place by sewing one section of the artery or vein around a tiny opening just below the blockage in the diseased coronary artery and attaching the other end to a tiny opening made in the aorta. This redirects the blood flow around the blockage. If an internal thoracic (mammary) artery is used, one end is connected to the coronary artery while the other stays attached to the aorta.
During the surgery, your surgeon will place temporary pacing wires and a chest tube before your sternum is closed with special wires. Your chest incision will be closed with internal stitches or traditional external stitches. The chest tube is needed to drain fluid. The pacing wires are placed in case you have an abnormal heart rhythm after surgery. This is common, and if it happens, the wires are attached to a temporary pacemaker until your heart rhythm returns to normal.
The surgery generally lasts 3 to 5 hours, depending on the number of arteries that are being bypassed.
You will start your recovery in an intensive care unit (ICU). You will stay in the ICU for 1-2 days so your healthcare team can closely keep track of your condition and vital signs. You will continue your recovery in a step-down unit. Most patients stay in the step-down unit for 3-5 days.
It will take about two months to recover from surgery. In the beginning, you may feel worse than you did before surgery. This is normal and is usually related to the trauma of surgery, not how well your heart is working. The way you feel after surgery depends on your overall health, the outcome of the surgery, how well you take care of yourself after surgery, and how well you felt before surgery. Most patients feel better after they recover. Call your doctor if you are concerned about your symptoms or speed of your recovery.