What is Coronary By-pass?

Bypass literally means "bridging". Coronary artery can be defined as the artery that feeds the heart.

Coronary Bypass

With each contraction of the cabinet, some of the blood is sent to the lungs for oxygenation, while the other part is pumped to the main artery leaving the heart, namely the aorta. The aorta, which is approximately 3 cm in diameter at the point where it exits from the heart, branches after leaving the left ventricle of the heart, allowing clean blood to reach the whole body.

The first branch of the aorta is the coronary artery that feeds the heart itself. The diameters of the coronary arteries range from 1 to 3 mm. There are two arteries, right and left, and these arteries are responsible for feeding the heart.

What is Coronary Bypass?

When there is narrowing or occlusion in the coronary arteries that supply the heart, the heart cannot be adequately nourished and cannot function normally. begins to fail to perform and the person complains of chest pain and fatal problems such as heart attack (myocardial infarction) occur.

Coronary bypass surgery is a surgical intervention performed due to occlusion of the arteries (coronary) feeding the heart. For the bypass procedure, without causing loss of function at the place where they were taken, only the veins of the patient, such as the leg vein, forearm artery, chest artery, are used and these vessels are prepared and transferred to the patient area and blood circulation is restored.

How is Coronary Bypass Performed?

Coronary bypass surgery can be performed in two ways:

• Bypass in the stopped heart: While the heart is completely stopped and the circulation in the body is maintained by a heart pump, the process of bridging the vessels is performed. . The heart pump takes over the duties of the patient's lungs and heart during the operation and ensures that blood is pumped to the brain and other vital organs.
• Bypass in the working heart: The operation is performed without stopping the heart and without the need for a heart pump. In a beating heart, the risk of infection is much lower in coronary bypass operation, and the patient's recovery and discharge are quicker. In addition, the need for blood transfusion during the operation is low and risks such as stroke can be kept at a low level. It can also be done with the closed surgery method. After the method of coronary bypass operation is decided, the patient is anesthetized. Although coronary bypass operations are mostly performed under general anesthesia, local anesthesia may also be preferred in selected cases. The effect of the current health status of the person is great in determining the type of anesthesia. General anesthesia may not be applied to people with hypertension, diabetes and lung diseases as well as people with kidney dysfunction.

  Where to get a vein for coronary bypass?

  With the help of a sternum and bone saw for a vein to be taken from the chest The thorax is cut open. Generally, the mammary artery in the left breast is used. In the presence of more than one coronary artery that needs to be bypassed, the vein in the leg of the person or the radial artery in the arm, that is, the vein in the forearm that feeds the hand, can also be used. is removed. One end of the removed vessel is sutured to the coronary artery below the occluded area. The sternum is tied with strong wires and the surgical area is sutured.
  
  After the operation, the scar (scar) mark in the area where the vein is taken may be too small to be seen with the naked eye.

  Who Is Bypass Applied to?

  • Multiple veins disease,
  • Inability to open more than one coronary vessel with non-surgical (balloon and stenting) method,
  • Conditions requiring heart valve operation,
  • Inability to remove one or more vessels by non-surgical method Coronary bypass surgery is preferred if there is another heart condition requiring surgery.

  How Long Does Bypass Surgery Take?

  Total duration of coronary bypass surgery differs depending on whether the surgery is performed with open or closed method. In addition to the number of vessels to be bypassed, another factor affecting the duration of the operation is that the operation is performed on a working or stopped heart. Today, coronary bypass operations, which are mostly carried out with minimally invasive methods, can take approximately 3 to 6 hours. With the same operation, such as the change of the heart valve of the person, Other surgical interventions for the alveo cause prolongation of the operation time.
  

  What are the Bypass Risks?

  The risk of surgery depends on demographic factors such as the patient's age, gender, lifestyle and chronic diseases.
  
  The risk of loss of life is low in coronary bypass operations. However, factors such as the age of the person, accompanying diseases, how much of the heart muscle is damaged due to the heart attack, and the presence of loss of function in other tissues and organs increase the risk of surgery.
  Patients who experience psychological trauma after the operation may need psychological support.

  Bypass Final Solution Manager?

  As a result of bypass, vascular occlusions and narrowings are opened for the moment, but arteriosclerosis is the result of surgical intervention. does not disappear. The operation prevents the patient from having a heart attack, dying suddenly, and being restricted from society due to drug dependence.
  
  Patients should regulate their lives after the operation, avoid harmful foods and beverages, abandon their bad habits and live with quality. /li>

• Performing the first operation at an early age,
• Risk of atherosclerosis,
• Not bridging all vessels in the first operation,
• Diabetes (sugar) and kidney disease Accompanying chronic diseases such as disease,
• Continuing to smoke,
• Not treating high cholesterol and triglycerides adequately.

How Long Is the Recovery Process After Bypass Surgery?

The patient, who is released from the intensive care unit after the operation and whose breathing apparatus is removed, starts exercises with the help of a physiotherapist to remove the sputum accumulated in the bronchi during the operation. The patient needs to stay in the hospital for four to seven days. If everything is normal at the end of this period, the patient is discharged.
A week later, the patient is called for control again. During the visit to the outpatient clinic, the general condition of the patient is observed, his complaints are evaluated, and his medications are rearranged when necessary. In the presence of accompanying diseases such as obesity, hypertension, diabetes, the patient is provided with a cardiologist for comprehensive follow-up.
The patient is provided with varicose veins. He may need to use the nozzle. In the first phase of the recovery period, one should stay at home, but move without being tied to the bed. During this period, the patient may encounter problems such as not being able to turn sideways and driving, and full recovery occurs after six months.
The patient recovers completely when the cut bone and thorax heal during the operation. Any activity that a normal person would do, can go to work, drive a car.

How to Live After Surgery?

Preoperative physicians often have difficulties in changing their patients' lifestyles. . After the operation, patients who become aware of the bypass operation and the severity of the disease apply the recommendations more carefully.

Things to pay attention to:

• If the patient smokes, he/she should definitely quit immediately,
• Heavy sports should be avoided,
• Excessive weight, again the doctor

should use medications.
Regular visits to rehabilitation sessions after bypass are very effective in overcoming psychological trauma for patients who want to return to their old lives. Since sudden changes in the heart rate can cause heart problems, dangerous combat sports that use weights and have a very intense tempo should be avoided.

Swimming can be practiced because it is a sport that can work all the muscles in the body and can also do breathing exercises. If possible, regular nature walks should be made in the open and fresh air. Activities such as table tennis and dance that can be done with a partner also contribute to the health of the patient and enable him to socialize.
Regular cardiology examinations must be attended after the surgery.
Regular Check-Up is important in early diagnosis of all diseases, especially possible vascular occlusions. .

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