Language
Country/Area
No result found
Demystifying Heart Bypass: How Blocked Heart Blood Vessels Affect Our Health?
Heart bypass surgery is a surgical procedure designed to redirect blood flow by reconnecting blood vessels. This surgery is usually done to bypass a diseased artery and redirect blood flow from an area of normal blood flow to another, relatively normal area. This procedure is usually performed because of insufficient blood flow (ischemia) due to hardening of the arteries, but may also be performed as part of an organ transplant, or as a vascular access for hemodialysis. Generally speaking, a patient's own vein (autograft) is the graft of choice for heart bypass surgery, although other types of grafts are also used, such as polytetrafluoroethylene (Teflon), polyethylene terephthalate (Daclon) or a vein from another person (allogeneic transplant). In some cases, arteries can also serve as vascular grafts. The surgeon manually sews the graft to the donor and target vessels, creating a surgical anastomosis.
Common bypass sites include the heart (coronary artery bypass surgery), used to treat coronary artery disease, and the legs, where lower extremity bypass surgery is used to treat peripheral vascular disease.
Medical purposes
Heart bypass
Heart bypass surgery is performed when the arteries that supply the heart muscle (coronary arteries) become blocked by plaque. This condition may cause chest pain or a heart attack, and with proper evaluation and technique selection, the surgeon will select the appropriate material for vascular replacement.
Leg (lower limb) bypass
In the legs, bypass implants are used to treat peripheral vascular disease, acute limb ischemia, aneurysms, and trauma. Although there are various anatomical arrangements for lower extremity vascular bypass, the principle is the same: to restore abnormal blood flow. For example, if the femoral artery is blocked, a femoral-popliteal bypass ("fem-pop") may be used.
Hemodialysis access
Vascular bypasses are often used as access points for hemodialysis. If a vein and artery are connected directly without the use of synthetic materials, it is called an arteriovenous fistula.
Cerebral artery bypass
When the blood supply to the brain is blocked, cerebral artery bypass surgery may be needed to improve or restore blood supply. Two common types include direct and indirect revascularization, where direct revascularization involves directly connecting external cerebral arteries located outside the brain to arteries within the brain.
Evaluation
Before constructing a bypass, most surgeons will perform imaging studies to determine the severity and location of the diseased vessel. For diseases of the heart and lower limbs, this is usually done by angiography; while assessment of hemodialysis may be done by ultrasound.
Contraindications
Lack of suitable intravenous access is a relative contraindication to bypass surgery, and depending on the site of the disease, other alternatives may be considered. In addition, conditions that increase the risk of surgery, such as ischemic heart disease or chronic obstructive pulmonary disease, are also considered relatively contraindicated.
Surgical techniques
Standard Technology
The basic principle of vascular bypass technique is to obtain proximal and distal control to minimize blood loss when opening the vessel. After the desired exposure, clamps are typically applied to the proximal and distal ends of the vessel.
ELANA Technology
In neurosurgery, nonocclusive anastomosis (ELANA) is a technique for performing bypass surgery without interrupting blood flow to the recipient, with the goal of reducing the risk of stroke or aneurysm rupture.
Risks and Complications
Several complications may occur after vascular bypass. For example, acute graft occlusion may occur shortly after bypass, requiring urgent reoperation. In addition, there are the usual risks of surgery, including bleeding, infection, and embolism.
Recovery process
After coronary or neurosurgical bypass surgery, patients typically stay in the intensive care unit or coronary care unit for one to two days. If recovery returns to normal without complications, transfer to a ward with less close monitoring may be possible. For lower limb bypass surgery, recovery will also start in a less monitored ward depending on the extent of the surgery.
Postoperative monitoring focuses on detecting signs of bleeding and graft occlusion. If bleeding is detected, treatment may range from blood transfusions to repeated surgery.
Patients are usually prescribed oral analgesics at discharge, and if there are no contraindications and the procedure is for arteriosclerosis, statins and antiplatelet drugs should be prescribed. Some patients feel back to normal after a month, while others may still have problems months after surgery. Is recovery from heart bypass surgery achievable to a healthier quality of life still dependent on the patient being able to make the necessary lifestyle changes?
