Open heart Surgery / Coronary Artery Bypass Graft?

Question

Sorry I put this in the wrong category ….so I’ll try one more time….. My brother will be having this procedure this coming Tuesday…if any of you guys know of someone or has experience this yourself…can you please tell me…..just how serious this is and what will happen to his health after its done….the doctors gave some information but it was mostly statistics….I kind of one to know from individuals who lived with it …thanks for taking the time to reply

Answer 1

You sound worried and personally the more I understand about something the better I can deal with it. If I had more info about your brother I could be more detailed but I will try to give you an overview of what to expect. This is quite lenghty, but hopefully it helps.

First, if the surgery isn't done it could be serious. What has happened to your brothers heart is the blood vessels that actually bring blood to the heart muscle (not into the heart to be pumped but actually bring nutrients and oxygen to the heart muscle its self) have become clogged with cholesterol, like your plumbing can get clogged with sludge. The cholesterol sticks to the sides of the blood vessels and hardens over time. Then more layers of cholesterol get stacked on the others and over time the blood vessel gets blocked and blood can't get thru to the heart muscle. When a muscle doesn't get enought oxygen it will first cramp to let you know something is wrong. In the heart this causes the symptoms of chest ,arm or jaw pain or indigestion to name a few. If the problem isn't fixed the part of the heart muscle that gets blood from the blood vessel that is blocked will begin to die. This is called a heart attack or myocardial infarct (myo-muscle; cardio-heart, infarct -lack of oxygen). There are several different blood vessels or cardiac arteries that feed the heart. Depending on how many blocked areas there are and where will depend on how many bypasses there will be. Some people have a double or triple bypass. This means that there are 2 (double) or 3 (triple) areas that need to be bypassed. The more bypassed areas the more serious. They usually take a vein out of the lower leg and use it as a graft in the heart. They will attach a part of the vein in front of the blockage and then attach the other part of the vein on the other side of the blockage. this will now allow blood to flow freely bypassing the blockage. To do this procedure he will have to have his breast bone opened so the surgeon can get to the heart. He will have staples down the incision on his chest and he may be on a ventilator for a little while. The faster they get him off the ventilator (breathing machine) and sitting up in a chair the better he will do. They will try to get him out of the ICU and up to the floor as quick as possible. Some patients do so well they will discharge them home straight from the ICU. After he goes home he will have to be careful not to lift anything over a couple of pounds. If he is young and his heart is the only problem he has the chances he will do well are very good. If he has other things wrong with him like diabetes or breathing problems that will prolong the healing time. Once the surgery is over and the grafts are working. They will be watching for signs of bleeding from the graph sites and signs of infection to the incision site. I hope this helps. You can email me more specific questions if you like. I worked as an ICU nurse. In my opinion the better you understand what is happening the better able you will be to help care for and support your brother. May everything go well!!

Answer 2

1

Answer 3

Firstly you should understand one thing -that is : open heart surgery is different and Coronary Artery Bypass Grafting (CABG) is different. Open heart is the proceedure done inside the heart such as change of valve etc. and CABG is done in the outside arteries.

I am a patient and I had surgery with 4 CABG grafting in 1991 and again a surgery with 3 CABG grafting in 2002. Now I am alright. Now a days a sucess rate of 99% is being obtained and you need not worry. It has become very common surgery.
So do not worry. Now for further learning please read -

Coronary artery bypass graft surgery is a surgical procedure in which one or more blocked coronary arteries are bypassed by a blood vessel graft to restore normal blood flow to the heart. These grafts usually come from the patient's own arteries and veins located in the leg, arm, or chest.

Purpose

Coronary artery bypass graft surgery (also called coronary artery bypass surgery, CABG, and bypass operation) is performed to restore blood flow to the heart. This relieves chest pain and ischemia, improves the patient's quality of life, and in some cases, prolongs the patient's life. The goals of the procedure are to enable the patient to resume a normal lifestyle and to lower the risk of a heart attack.

The decision to perform coronary artery bypass graft surgery is a complex one, and there is some disagreement among experts as to when it is indicated. Many experts feel that it has been performed too frequently in the United States. According to the American Heart Association, appropriate candidates for coronary artery bypass graft surgery include patients with blockages in at least three major coronary arteries, especially if the blockages are in arteries that feed the heart's left ventricle; patients with angina so severe that even mild exertion causes chest pain; and patients who cannot tolerate percutaneous transluminal coronary angioplasty and do not respond well to drug therapy. It is well accepted that coronary artery bypass graft surgery is the treatment of choice for patients with severe coronary artery disease (three or more diseased arteries with impaired function in the left ventricle).

Procedure

The surgery team for coronary artery bypass graft surgery includes the cardiovascular surgeon, assisting surgeons, a cardiovascular anesthesiologist, a perfusion technologist (who operates the heart-lung machine), and specially trained nurses. After general anesthesia is administered, the surgeon removes the veins or prepares the arteries for grafting. If the saphenous vein is to be used, a series of incisions are made in the patient's thigh or calf. More commonly, a segment of the internal mammary artery will be used and the incisions are made in the chest wall. The surgeon then makes an incision from the patient's neck to navel, saws through the breastbone, and retracts the rib cage open to expose the heart. The patient is connected to a heart-lung machine, also called a cardiopulmonary bypass pump, that cools the body to reduce the need for oxygen and takes over for the heart and lungs during the procedure. The heart is then stopped and a cold solution of potassium-enriched normal saline is injected into the aortic root and the coronary arteries to lower the temperature of the heart, which prevents damage to the tissue.

Next, a small opening is made just below the blockage in the diseased coronary artery. Blood will be redirected through this opening once the graft is sewn in place. If a leg vein is used, one end is connected to the coronary artery and the other to the aorta. If a mammary artery is used, one end is connected to the coronary artery while the other remains attached to the aorta. The procedure is repeated on as many coronary arteries as necessary. Most patients who have coronary artery bypass graft surgery have at least three grafts done during the procedure.

Electric shocks start the heart pumping again after the grafts have been completed. The heart-lung machine is turned off and the blood slowly returns to normal body temperature. After implanting pacing electrodes (if needed) and inserting a chest tube, the surgeon closes the chest cavity.-

Answer 4

I am a nurse and had to do a large report on CABG (Coronary Artery Bypass Graft) and have taken care of many patients that have had this done. It is a relatively complex surgery, however one of the more common ones.

Your brother's health will improve drastically after his healing (about 6-10 weeks for full healing). 2/3 of the veins will last about 10 years after this proceedure. This surgery will increase his energy. He won't be as tired all the time and his vital systems will function better. During his healing he will be limited in what he can do. This is not a surgery that doctors perfom just for the heck of it. If they are going to do this surgery it is because he needs it and he will benefit from it.

This website is fairly good at answering all the facts. This will explain all the surgery that would take pages to copy and paste into the response.
http://www.medicinenet.com/coronary_artery_bypass_graft/page4.htm

Answer 5

2

Answer 6

I answered your other posting too, I had a triple bypass done in 1993 and am still going strong, any questions feel free to email me at [e-mail]

Answer 7

Coronary artery disease (CAD) occurs when atherosclerotic plaque (hardening of the arteries) builds up in the wall of the arteries that supply the heart. This plaque is primarily made of cholesterol. Plaque accumulation can be accelerated by smoking, high blood pressure, elevated cholesterol, and diabetes.

CABG (coronary artery bypass graft) surgery is performed to relieve angina in patients who have failed medical therapy and are not good candidates for angioplasty (PTCA). CABG surgery is ideal for patients with multiple narrowings in multiple coronary artery branches, such as is often seen in patients with diabetes. CABG surgery has been shown to improve long–term survival in patients with significant narrowing of the left main coronary artery, and in patients with significant narrowing of multiple arteries, especially in those with decreased heart muscle pump function.

The cardiac surgeon makes an incision down the middle of the chest and then saws through the breastbone (sternum). This procedure is called a median (middle) sternotomy (cutting of the sternum). The heart is cooled with iced salt water, while a preservative solution is injected into the heart arteries. This process minimizes damage caused by reduced blood flow during surgery and is referred to as "cardioplegia." Before bypass surgery can take place, a cardiopulmonary bypass must be established. Plastic tubes are placed in the right atrium to channel venous blood out of the body for passage through a plastic sheeting (membrane oxygenator) in the heart lung machine. The oxygenated blood is then returned to the body. The main aorta is clamped off (cross clamped) during CABG surgery to maintain a bloodless field and to allow bypasses to be connected to the aorta.

CABG surgery takes about four hours to complete. The aorta is clamped off for about 60 minutes and the body is supported by cardiopulmonary bypass for about 90 minutes. The use of 3 (triple), 4 (quadruple), or 5 (quintuple) bypasses are now routine. At the end of surgery, the sternum is wired together with stainless steel and the chest incision is sewn closed. Plastic tubes (chest tubes) are left in place to allow drainage of any remaining blood from the space around the heart (mediastinum). About 5% of patients require exploration within the first 24 hours because of continued bleeding after surgery. Chest tubes are usually removed the day after surgery. The breathing tube is usually removed shortly after surgery. Patients usually get out of bed and are transferred out of intensive care the day after surgery. Up to 25% of patients develop heart rhythm disturbances within the first three or four days after CABG surgery. These rhythm disturbances are usually temporary atrial fibrillation, and are felt to be related to surgical trauma to the heart. Most of these arrhythmias respond to standard medical therapy that can be weaned one month after surgery. The average length of stay in the hospital for CABG surgery has been reduced from as long as a week to only three to four days in most patients. Many young patients can even be discharged home after two days.

Answer 8

CABG is an opened heart surgery.