Coronary artery bypass surgery is a type of cardiothoracic surgery, or chest surgery, which reroutes - or bypasses - the flow of blood around arteries which are clogged. This improves the flow of blood and oxygen to the heart. Coronary arteries are the arteries through which blood flows to the heart. They can sometimes become clogged by the build-up of cholesterol or fat. This clogging slows or stops the flow of blood to the heart, which in turn can lead to pain in the chest, or even a heart attack. The motive behind a cardiac bypass surgery is to increase the flow of blood to the heart to restore optimal heart functioning.
The cardio-surgeon takes a piece of blood vessel from the chest or leg of the patient and grafts it onto the aorta, the artery which leaves the heart, and then he grafts the other end to the coronary artery beneath the block, thus creating a detour around the arterial blockage. The number of bypasses - single, double, triple, quadruple - refer to how many coronary arteries are bypassed in the operation, which depends upon the number of blocked coronary arteries. A triple bypass surgery means that three coronary arteries are bypassed. In some bypass operations, a heart lung machine is employed to maintain the flow of blood and oxygen to the heart during the procedure.
When the cardiac bypass surgery is over the patient is placed in the intensive care unit (ICU) so that the heart rate and the blood pressure can be monitored continuously for a day or so. Medication which regulates blood pressure and circulation are given intravenously, and a breathing tube may be used until the patient is able to breathe alone. The patient may feel disoriented and groggy upon awakening. The places where incisions have been made may be painful, so painkilling medications may be given, if needed. Normally, patients remain in the hospital for 3 to 5 days, and sometimes longer. After being released from the hospital some patients suffer side effects such as pain and swelling in the places from which blood vessels were harvested, and pain in the muscles of the shoulders and back. Constipation and appetite loss are sometimes experienced.
Also some patients suffer fatigue, depression, and insomnia. In most cases, these side effects disappear within a month or two. Normally, patients are placed in cardiac rehabilitation programs under the supervision of a cardiologist. These programs teach exercise, diet, and techniques to manage stress. Patients recovering from cardiac bypass surgery are advised to walk and engage in physical activity, and also to eat less cholesterol and fat, in order to return to a normal lifestyle as soon as possible. Patients with sedentary work in offices can usually return to the job in a month or two those with employment which is more demanding physically may take longer, or necessitate a change of jobs.
Modern cardiothoracic surgery has benefited immensely by the introduction of minimally invasive robotic heart bypass surgery. This new technique uses much smaller incisions than traditional methods, which results in faster healing, fewer side effects, and a shorter hospital stay. This technique is quickly adopted by leading hospitals in India.