We will have a quick overview on the different heart bypass surgeries. A single coronary artery blocked or damaged by a heart attack will undergo coronary artery bypass graft surgery. Then it follows that if there are two arteries affected bypass will be double, if three arteries, triple bypass and for four arteries, quadruple bypass surgery. The prefix corresponds to the number of coronary arteries which are blocked or affected. They also refer to the number of coronary arteries which should be grafted.
In a triple bypass heart surgery, three arteries are affected while the quadruple bypass heart surgery deals with four blocked arteries. The blood that flows from the coronary arteries through the heart is hindered by plaque or fatty deposits. The blockage produces muscle pains and eventually leads to a heart attack. The blood flow which produces oxygen as supplied to the heart to keep it pumping. But with the onset of heart attack blood flow will stop. The person who has a heart attack caused by a blocked coronary artery is left with no other choice but to undergo coronary artery bypass graft surgery.
This surgical procedure involves opening the heart of the patient and taking out a healthy blood vessel from another part of the body, to be grafted or attached to the damaged coronary artery. In triple bypass heart surgery, three veins or coronary arteries are needed while four coronary arteries are grafted in quadruple bypass heart surgery.
Before the surgery, the patientmust be physically well and strong enough to endure the procedure. As frail, weak patient may be advised against surgery and wait until the condition gets better.
The complete blood count, urine tests, x-rays and other laboratory tests should have manifest normal results. I. The patient’s blood pressure should be closely monitored as well. The patient should undergo further testing through electrocardiogram and coronary angiogram to check his heart’s condition or status. The surgeon will now assess based on the test results.
A medical clearance showing normal results will most likely qualify the patient for bypass heart surgery. If a patienthas other illness, a collaboration with the patient’s attending physician is required for other relevant laboratory tests. Both the physician and the surgeon will work in close coordination for the surgery in order to make sure that the patient is fit for the procedure.
At the surgical room, the patient will be given the exact dosage of general anaesthesia for the surgery. A tube that is place on the patient’s mouth is attached to the ventilator. In that way the patient will be able to breathe comfortably while the surgery is ongoing. With anaesthesia, the patient is not allowed to talk. A pen and paper is provided beside the patient to write on anything that he wants to say prior to the surgery itself. The patient will feel drowsy and eventually fall asleep. Surgery will start as soon as the patient becomes unconscious. The duration of the surgery will depend on the equipment used but it usually lasts a few hours.
The patient will have to stay for few days or couple of weeks for close monitoring. The patient after surgery should have normal heart beats, consistently normal vital signs, and shouldn’t have any difficulty in breathing. Upon full recovery of the patient, he will be discharged from the hospital. But sending the patient home doesn’t mean that there is no more risk for the other arteries to get blocked or damaged. Fact is, bypassed arteries may be blocked again but not for another ten to fifteen years and depending on the patient’s lifestyle after the surgery.
Here are the reported serious as well as mild complications of the surgery, either triple bypass surgery of quadruple bypass surgery. The injection of general anaesthesia on the patientcould lead to serious problems like state of shock and heart collapse. It would take time to revive the heart and may be fatal to the patient. The mild allergic reactions of the patient are nausea and vomiting.
Another risky complication during the surgery is the bleeding of the organs near the heart or the heart itself. It would imply great loss of blood from the patient and would require bags of blood to transfuse and replace the loss. The patient must be prepared with bags of blood with the same blood type ahead of time. Blood clotting may also take place during the surgery. There is a machine called heart- lung bypass that assists the surgeon to keep the blood from the heart to divert the flow through the machine.
Memory loss is another mild complication after the surgery. The lack of sleep and narcotics injected cause confusion and memory loss. Often times, this will only last for a few days and soon after the patient will regain his memory again.
Lastly, the worst surgery complication is infection. The infection may start from the incised area of the chest and getting vast penetration inside. It may reach the immediate organ involved in the surgery which is the heart. Infection may affect other organs like the lungs and the bladder. If it affects the lungs it may lead to pneumonia and the bladder infection may lead to cystitis. Infection could also travel through the bloodstream that may lead to sepsis.
It must be countered with strong and costly antibiotics given to the patient through intravenous fluids. The vial is injected directly to the intravenous fluid that penetrates the veins of the patient. The patient who has acquired sepsis stays at the hospital for few weeks to have the infection fully reversed. Sepsis is a fatal infection if left untreated.
The presence of other illness lengthens the recovery period of the patient. The span of recovery varies from case to case. Some may undergo cardiac rehabilitation for few weeks after the surgery while others may be physically well after few weeks of suffering from pain after the surgery. Some may still be sensitive in the coldness of the weather for few months, which will constantly cause chest pain. A recovery period varies from two months until a year. It is when their hearts have fully recovered that they can go back to their daily routine without any hassles for the heart. But there are some who may not recover from the surgery and adds to the fatality rate.