Triple Bypass Heart Surgery
Triple bypass surgery
- Triple bypass surgery is also known as coronary bypass surgery, coronary graft surgery and/or CABG [Coronary Artery Bypass Graft surgery].
- Triple bypass surgery is performed in case of three blockades in the coronary artery.
- The coronary artery is a blood vessel that originates from the aorta and is responsible for supplying oxygenated blood to the heart.
- At times, a blocking is developed in the coronary artery, leading to low or no supply of oxygenated blood to the heart.
- Such a condition can lead to stroke and damage to the cardiac tissue.
- In triple bypass or coronary bypass [coronary graft surgery], a graft is implanted or affixed to the damaged artery.
- The position of this graft is just beyond the blockade. Due to this, blood flow is redirected, the block is bypassed and the blood flows smoothly to the tissues.
Indications/ Need for Triple bypass surgery.
- Severe chest pain or Angina.
- Formation of Plaque in the artery.
- Stroke [Heat attack], caused mainly due to an inadequate blood supply.
- Diseased or damaged blood vessels.
- Shortness of breath or heavy breathing is experienced along with angina.
Precautions before Triple bypass or CABG SURGERY
- A complete blood test is done to check the various levels of blood components in the blood. The levels of RBC should be optimum to avoid complications during transfusion.
- The thrombin level should be checked as low levels of these means thinner blood and its loss to form clot and ability of wound healing.
- Blood sugar level should be controlled and maintained in the optimum range to avoid complications during wound healing.
- A chest x-ray is taken to determine the proper site, position and site of the damaged artery, state of the lung and heart tissue.
- A test called cardiac catheterization is done to evaluate the extent and exact position of the blockade.
Precautions during Triple bypass/ CABG surgery.
- The patient is administered with general anaesthesia.
- A breathing tube is passed through the mouth to aid in breathing during the procedure and afterwards.
- An incision in the centre of the chest, just above the sternum [collar bone].
- The collarbone is cut into two vertically and rib-cage is pulled apart in such a manner, that the surgeon can access the heart, lungs and affected coronary artery.
- The heart, lungs and associated networking [circulatory system] are connected to a device called cardiopulmonary bypass pump or heart-lung machine throughout the procedure. This device takes over the function of the circulatory system. The heart is treated with a drug which temporarily stops the heart from beating.
- The graft used is obtained from 2 sources. One being the internal thoracic artery from the chest and the second being the saphenous vein in the leg. If the graft used is an internal thoracic artery, then one end is left attached to the subclavian artery [an artery supplying blood to the thorax, head and arms] while the lower end is shifted and pulled over to the affected area.
- This end is sewed just beyond the blockage on the coronary artery.
- If the graft used is that from the saphenous vein, the surgeon attached on end to the aorta and the other end to the area just below or beyond the blockage.
- After sewing up the grafts, the heart is treated with electrical shock. This jump-starts the heart and it beats again.
- A pacemaker is affixed temporarily to aid the beating of the heart.
- The heart-lung machine is disconnected only after the heart starts beating normally again.
- The breastbone or sternum is joint and the incision is sewed back by the surgeon.
- A drainage tube is affixed at the site of the procedure through a small hole in the skin.
- The patient is kept in the Intensive care unit for 2 days and vitals such as the blood pressure, breathing rate, electrical activity of heart and heartbeat is monitored 24/7.
- The breathing tube is logged in the throat till the patient acquires full consciousness and is capable of breathing independently.
- One should cough out during the recovery period to avoid any fluid build-up in the lungs.
- The patient will experience a loss of stamina and experience panting due to a weak cardiovascular and pulmonary system.
- The patient is not allowed to carry out activities such as extensive running, sexual activities or exercise as these strain the cardiovascular and pulmonary system and can aggravate the situation and lead to a chest injury, damage to the wound or the site of procedure and lead to complications.
- However, one can resume these activities after 2-3 months’ time.
Facts and Myths
- The patient will experience loss of stamina.
- Fever and redness in the chest area is observed. In such cases, please consult the physician.
Risks and Complications
- Bleeding at the site.
- Formation of blood clots.
- Arrhythmia or irregular heartbeat.
- A patient is kept in ICU for 2 days’ time.
- Discharge is granted after 2 weeks.
- Full recovery takes 3 months.