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The amazing heart bypass operation


October 2013

 

 

“Oh, he is in hospital for a heart bypass operation.” The words heart bypass, or even triple of quadruple heart bypass, have become so common place it is hard to appreciate the stunning breakthrough this surgery offers compared with what was available when we were young.

An amazing 28,000 heart bypass operations are performed in the UK every year, or around 70 operations every day. Most of the patients are over 60 years old and far more men than women undergo this surgery.

We all know our hearts need a constant supply of blood. This comes from two large blood vessels called the left and right coronary arteries. As we age, these arteries can become narrowed and hardened by a build-up of fatty deposits called plaques.  This restricts the flow of blood to the heart and this condition can be known as atherosclerosis or coronary heart disease.  This can lead to angina, a chest pain that occurs when the supply of blood to the heart becomes restricted.

 So much for all the medical names, but it comes down to the fact that when the restriction is too severe then patients can be offered a heart bypass operation to help improve the blood supply to the heart. This can greatly improve quality of life and of course in some cases can be a truly lifesaving operation.

The bypass aims to get around the narrowed sections of the coronary arteries, usually by grafting a blood vessel from elsewhere in the body to link an area between the aorta, the main blood vessel leaving the heart, to a point along the coronary artery beyond the affected area. In other words, bypassing the problem area which is restricting the blood flow.

Often, the blood vessel used for the bypass is taken from an artery in your chest called the internal mammary artery, but other blood vessels such as a vein from your legs or an artery from your arms can be used.

To do the operation, the surgeon often needs to cut down the middle of the breastbone to reach the heart and this means you are left with a long wound. While the operation is taking place, a heart-lung bypass machine circulates the blood around your body while the surgeon operates on your heart.

It is unusual just to have one bypass and more often a patient will have two, three or four  bypasses put in at the same time to avoid a number of narrowed sections. These are what are termed as double, triple or quadruple bypasses.

After the operation, a patient will be moved to intensive care for careful monitoring and then onto a high dependency unit or cardiac award for recovery. This obviously happens at different speeds depending on the health of the patient and the level of the operation, but recovery can be surprisingly fast. Generally patients can sit in a chair after one day and begin to walk after three days.

The outlook is generally good and many people will find their symptoms have reduced or disappeared plus any risk of a heart attack will have been reduced as well.  However, a heart bypass operation is not a cure for coronary heart disease and the new grafted arteries can in turn become narrowed or hardened by unhealthy diets and lifestyles.

Despite the number of operations being undertaken, nevertheless heart bypass surgery is still a very serious operation and complications can occur. Other conditions such as kidney disease can affect the outcome.  People aged 70 and above are at a higher risk of complications.



 

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