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The technology behind the surgery: How is heart bypass surgery actually performed?
Coronary artery bypass grafting (CABG) is an important procedure to treat coronary artery disease, a condition caused by the buildup of plaque in the heart's arteries, which leads to narrowing of the blood vessels and can eventually cause a heart attack. The main purpose of this surgery is to relieve chest pain caused by narrowed arteries and to improve the patient's quality of life. During the surgery, doctors use an artery or vein harvested from elsewhere in the patient's body to bypass the damaged blood vessel and restore blood supply to the heart.
Heart bypass surgery is designed to prevent death from coronary artery disease and improve quality of life by relieving angina pain.
Awareness of Coronary Artery Disease
Coronary artery disease is a common heart disease. The main cause of the disease is the narrowing of the coronary arteries due to the formation of plaques, which directly affects the blood supply to the heart and may cause myocardial ischemia. Symptoms range from no symptoms to angina during exercise, and chest pain may be felt even at rest, a condition called unstable angina. If blood flow is not restored within hours, the damaged heart muscle can begin to die, which can lead to more serious health problems.
When to use heart bypass surgery
Stable patients
Medications are usually used first to treat stable patients with chest pain. There are a number of noninvasive tests that can help determine if a patient is a good candidate for cardiac catheterization, including electrocardiogram and echocardiogram. If the test shows that part of the heart is not getting enough blood, a cardiac catheterization may be recommended to further decide whether to have heart bypass surgery or percutaneous coronary intervention (PCI). In some cases, CABG surgery provides a survival benefit over PCI.
Acute Coronary Syndrome
When faced with an acute cardiac event, quickly restoring blood flow to the heart is critical. Patients are usually admitted to the hospital because of chest pain. Doctors will first give them strong drugs to prevent blood clots. If percutaneous interventional treatment does not work, emergency CABG surgery will be performed.
The timing of surgery is critical to survival and should be delayed if feasible.
The process of heart bypass surgery
Preoperative examination
Before surgery, your doctor will perform a complete physical exam, including a chest X-ray and blood tests, to understand your overall health. Once available vessels are identified, the surgical strategy will be planned to determine which arteries or veins will need to be bypassed.
Surgery using an extracorporeal circulation machine
Usually, the first step of the operation is to put the patient under anesthesia and then open the chest to obtain the blood vessels needed for the bypass. Next, an extracorporeal circulation system will be established, which will maintain oxygen in the blood until the operation is completed. With the heart at rest, doctors perform a venous or arterial bypass, with the most critical step usually connecting the left internal mammary artery to the left anterior descending artery.
Operation without Extracorporeal Circulation (OPCAB)
In some cases, doctors may choose not to use an extracorporeal circulation system to bypass the patient, a procedure called OPCAB. At this point, surgery focuses on stabilizing the heart and operating directly on the beating heart, an approach that reduces the risk of complications.
Every step during the procedure requires extreme precision and coordination to ensure blood flow is restored and risks are minimized.
Postoperative Care and Outcomes
After surgery, the patient is usually transferred to an intensive care unit for observation. As the patient's condition stabilizes, most patients are able to be discharged from the hospital within a few days. During postoperative care, a variety of medications are used to help the heart function again and prevent complications.
The success of heart bypass surgery and the patient's recovery usually depends on the doctor's skill, the patient's health, and the postoperative care measures. According to the latest research, CABG surgery shows better long-term outcomes than PCI for patients with complex coronary lesions and other comorbidities.
Successful heart bypass surgery is not only related to medical technology, but also depends on comprehensive postoperative management and the patient's self-healing ability.
With the advancement of technology, the techniques and methods of heart bypass surgery are also constantly improving. Does this mean that there will be more effective treatment options in the future to meet the challenges of coronary artery disease?
