FREQUENTLY ASKED QUESTIONS
“NO DISEASE, THERE IS PATIENT”
The risk of surgery is determined according to the characteristics of the patient. These vary according to age, being a woman, Diabetes (insulin users), Lung Disease (COPD), Kidney Failure and the procedures to be performed besides bypass surgery.
1. What is coronary bypass surgery? Who gets the surgery?
Arteries called “coronary arteries” supply the blood needed by the heart.
Vascular occlusion and narrowing in the coronary arteries are shown by the patient’s chest pain and similar complaints by Coronary Angiography.
Since the heart can’t get enough blood for its needs, it can’t be fed enough. It may suffer from chest pain and heart attack. Every crisis means the death of a part of the heart muscle. After a while, the force of contraction of the heart decreases. Heart failure may develop. In order to avoid these risks, coronary artery bypass (bridging) surgery is performed from the main vessel aorta to supply blood down the clogged vessel. The name of this surgery is used as Aortocoronary Bypass.
2. How is bypass surgery done?
Bypass surgery is performed by cutting the sternum bone. Sometimes, single or two vessel bypass surgeries can be performed with small incisions under appropriate conditions. Aortic coronary bypass surgery is performed on the “working/beating” or “stopped” heart.
Classically, surgery is performed after the heart is stopped using the Heart Lung Machine. The heart is an extremely gentle and miraculous organ. The most frequently asked questions by patients are; How does the heart work after it is stopped? What if the heart doesn’t work?
With the Heart Lung machine, the heart is evacuated and stopped by administering a special fluid. There is no heart blood during this period. By reducing this special fluid and body temperature, energy expenditure of the heart is prevented. When the heart is filled with blood again, it works on its own. If it does not work very rarely, it is operated with a pacemaker. The heart cannot be removed during surgery. This is a false belief. The vast majority of surgeries are performed with this technique.
“Bypass in the beating heart” is generally started by applying it to higher risk individuals. It is preferred to protect the patient from some postoperative complications. Patients recover more easily and quickly. Today, the majority of patients are operated in this way. It is not suitable for use in calcareous veins with common atherosclerosis.
3. Which vessels are used for bypass? Would using these veins cause a problem?
Leg vein (Saphene Vein), forearm artery (Radial Artery) and thoracic artery (IMA) are used for bypass surgery. The first choice is the Thoracic Artery, as it is suitable for the arterial structure of the coronary arteries. Left frequency is used. Sometimes right and left are used together. The pectoral artery is located on either side of the sternum. In the second place, the radial artery and finally the leg vein are used. Most often, veins taken from the chest and legs are used. Thoracic and Arm arteries in the arterial structure are advantageous in terms of remaining open. These veins are what I prefer.
Removing these veins is not harmful. Instead of these veins, backups work. It does not cause a function deficiency or disorder.
In this technique, MINIMAL INVASIVE BYPASS surgery is performed with small incisions that extend to the side without cutting the sternum for single or two vessel bypass surgery.
4.Is bypass a risky surgery?
Explaining detailed information about the risk of bypass operation with a video under a separate topic. You can get information from that section.
VIDEO
5. How long does bypass surgery take?
There are different periods for individuals to have more than one vessel replaced. In general, the time to enter and exit the operating room; It also includes the surgical preparation and exit stages. In general, the time for the three-vessel bypass varies between 3-4 hours. It may take even shorter.
6. When do patients wake up after bypass surgery? How long will you stay in the Intensive Care Unit?
These types of surgeries are major surgeries. Patients are not awakened immediately after surgery. Under normal conditions, they regain their full consciousness within 4-6 hours. During this period, they are monitored in the ventilator. After all goes well, they leave the ventilator.
In the normal course, the duration of stay in the Intensive Care Unit is 24 hours. If everything goes well, the patients go to the service the next day. There are chest tubes at the surgery site when going to the service. These are also removed within 24-72 hours.
7. How long is the hospital stay after bypass surgery?
Generally, patients are discharged within seven days. Some patients have a rapid recovery period and are discharged on the 5th day. It is essential for the patients to get up and walk around the service in the early period and to do breathing exercises for early discharge.
After this operation, it is necessary for the patient to drastically change his previous lifestyle. Eating and drinking patterns, medication use, travel schedule, sports activities and daily life should be followed in line with the doctor’s recommendations.
8. What should patients pay attention to after bypass surgery?
Diet is important after bypass surgery. A diet from a nutrition and diet specialist is recommended. Each patient may have a different diet. Does the patient need a previous life change?
There may be loss of appetite and indifference to meals after surgery. There may be some weight loss during this period. Patients start to eat when they feel better. They gain weight. During this period, it is especially necessary to avoid gaining weight.
9. Control and removal of sutures after bypass surgery?
After discharge, a control appointment is given one week later. Stitches are removed in the control. The patient is examined by chest X-ray, ECG and blood tests.
10. Does the character of the person undergoing bypass surgery change?
According to the observations of the relatives of some patients, some of the patients may take on a calm personality when they are calm, nervous or angry. These changes are short-lived. It will return to normal in a short time. Very rarely, short-term anger and aggression can be seen.
Some studies have shown that there may be problems with near-term memory. These patients return to normal within 3-4 days.
11. Is sexual life adversely affected after bypass surgery?
After the surgery, it is necessary to wait for the bone to heal from the bone for sexual intercourse. This period is 4-6 weeks. People can also drive after this period. Sex life can be adversely affected. Reluctance or short-term erectile dysfunction may occur. Some medications can also cause erectile dysfunction. It is not recommended for patients to use drugs such as viagra in the early period. It is necessary for the patient to decide on the use of such drugs in consultation with his doctor.
12. Controls after bypass surgery?
Patients have their first check-up one week after discharge after surgery. Subsequent checks are made after 1 and 3 months. In the advanced period, patients should have check-ups at least twice a year. Preferably, it is recommended that they be checked by the same doctor.
KEY: bypass surgery, cardiovascular surgery, bypass, risk of bypass surgery, bypass, heart, cardiovascular surgery, heart, serdar akgün
