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5 things to know about bypass surgery

When a doctor recommends you or a loved one undergo coronary artery bypass surgery, you will have many questions about the procedure.

"Coronary artery bypass grafting, often referred to as CABG, is one of the most commonly performed cardiac surgeries worldwide," says Lake Regional Cardiovascular-Thoracic Surgeon Randy G. Brown, M.D., FACS. "Although CABG can sometimes be an emergency surgery, such as after a heart attack, usually a patient will have time to prepare for the surgery. Being educated on what to expect before, during and after surgery is the best way for patients to feel confident and to improve their overall experience."

Here are five key points to know.

1. Bypass surgery improves blood flow to the heart. It may be needed when the heart's arteries have become narrowed or blocked by plaque. This condition — called coronary artery disease — can lead to chest pain (angina) or a heart attack. Often, bypass surgery is recommended when you have multiple heart blockages that can't be treated by placing a stent in an artery. The surgery reroutes blood around the blocked arteries, relieving angina and helping you avoid a heart attack.

2. You'll need to prepare for the surgery. For instance, your surgeon may ask you to make changes to your diet or medications. Also, you may need some tests to help determine the extent of your heart blockages. And you will want to arrange for assistance after the surgery.

"Preparations also should include education on risks that can occur during and after the surgery," Dr. Brown says. "Some possible problems are myocardial infarction, acute renal failure, stroke, bleeding and sternal complications. Your surgeon will
explain how to recognize warning signs and what to do if concerned."

3. You'll be asleep for the procedure. If you're having traditional bypass surgery, the surgeon will operate through your opened chest.

A machine will pump your blood while your heart is temporarily stopped. Your surgeon will then take healthy arteries or veins (grafts) from other parts of your body and connect them above and below the blockages, creating a new route for blood to reach your heart.

You may have multiple bypass grafts if multiple arteries are blocked.

4. After surgery, you will stay in the hospital for about a week. Your surgeon will tell you when you can resume work or other activities. It can take several weeks to recover fully from bypass surgery.

5. While bypass surgery treats heart disease, it doesn't cure it. You'll still need to make healthy changes, such as managing your weight, eating healthy foods and not smoking. And you will need to take prescribed medications. You also may benefit from participating in a cardiac rehabilitation program, which your doctor
will prescribe.

"CABG provides great results that last for many years for most people," Dr. Brown says. "However,
for the best long-term outcome, patients also have to prioritize healthy lifestyle choices."

Sources: American Heart Association; National Heart, Lung, and Blood Institute

Two types of heart doctors

What's the difference between an interventional cardiologist and a cardiovascular-thoracic surgeon?

Cardiologists and cardiovascular-thoracic surgeons are two types of heart doctors. Cardiologists specialize in diagnosing and treating heart disease, and they are the primary doctor patients see when they have heart-related issues. Although most interventional cardiologists can perform procedures that require small incisions, such as angioplasty or cardiac stenting, they are not surgeons.

When a more complex heart procedure is necessary, such as CABG, that's when you'll need a cardiovascular-thoracic surgeon. The cardiologist will work with the surgeon to determine necessary treatments. Cardiovascular-thoracic surgeons typically manage patient needs directly following surgery and then transfer long-term care to the cardiologist.

Categories: Cardiology

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