Bypass Surgery: A Lifeline for Heart Health

By Dr. Vishal Khullar in Cardiothoracic and Vascular Surgery Unit

Jul 01 , 2023 | 2 min read

Bypass Surgery, or Coronary Artery Bypass Grafting (CABG), stands as a cornerstone in the comprehensive treatment of coronary artery disease. A lifesaving procedure, it enhances blood flow to the heart by circumventing the blocked arteries. This quintessential cardiac intervention plays a pivotal role in the services provided by our quaternary care hospital in India.

Understanding Coronary Artery Disease:

Coronary artery disease occurs when the major vessels supplying blood, oxygen, and nutrients to the heart get damaged or diseased, usually due to the build-up of cholesterol-containing deposits called plaques. As these plaques harden and narrow the arteries, the heart receives less blood, leading to symptoms like chest pain (angina) or a heart attack.

Bypass surgery is performed to relieve chest pain and increase blood flow to the heart muscle. It prevents damage to the heart muscle, improves the quality of life, and reduces the risk of death. Research has shown that in the presence of complex blockages, left main disease (blockage in the main artery of the heart), low pumping capacity of the heart, and in diabetic patients, bypass surgery seems to offer the best long-term results.

Who Needs Bypass Surgery?

Bypass surgery is generally recommended for patients with severe coronary artery disease involving multiple blockages, those who have not responded well to medications, or individuals whose lifestyle quality is significantly compromised. It's also performed emergently in patients experiencing a heart attack.

Types of Bypass Surgeries:

a) Beating heart bypass surgery

Beating heart bypass surgery is done on a beating heart without the use of a heart-lung machine. This technique is particularly useful in high-risk patients with serious organ dysfunction before surgery and is also associated with a lower risk of blood transfusions. With an experienced team, 90% of the bypass surgery cases can be performed on the beating heart.

b) On pump bypass surgery

On pump bypass surgery or conventional bypass surgery is performed with the use of heart-lung machine. In patients with rhythm disturbances of the heart and low blood pressure, On pump bypass surgery may offer better outcomes.

A Walkthrough of the Bypass Surgery Procedure:

During a bypass surgery, a healthy blood vessel (graft) is taken from another part of the body, often the leg, arm, or chest. This graft is then connected above and below the blocked artery, creating a new route for blood to flow to the heart muscle. Depending on the number of blocked coronary arteries, a single (one graft) or multiple (two to four grafts) bypass surgery might be performed.

Recovery and Rehabilitation Post Bypass Surgery

Post-surgery, patients typically spend a day or two in the intensive care unit (ICU) followed by a few days in the regular hospital ward. After discharge, the recovery continues at home for about 3-4 weeks. Comprehensive cardiac rehabilitation, including monitored exercise, nutritional counseling, and mental health support, forms an integral part of recovery.

The Role of Bypass Surgery in Long-term Heart Health:

Bypass surgery significantly improves symptoms of coronary artery disease, like chest pain and shortness of breath. It also boosts exercise tolerance, reduces the need for medication, and can even prolong life, especially in people with severe diseases.

Though bypass surgery stands as a lifesaver for patients with coronary artery disease, it's important to remember that an active, nutritious, and addiction-free lifestyle minimizes even the possibility of developing arterial blockages. A healthy life is the most reliable path to a healthy heart.