Are you afraid of coronary artery bypass surgery? Let's find out!

It's normal to feel a little scared and nervous when your doctor tells you or someone in your family that you need a bypass. Since this is a major surgery, you may have a lot of questions. "What is this?", "Why do I need this?", "Is this dangerous?" Things like that may come to mind. So today, let's talk about this bypass surgery, or Coronary Artery Bypass Grafting (CABG) as it is medically known, and some people affectionately call it "cabbage," and let's talk about it in simple terms.

Why do you need this bypass surgery?

Think of our heart as a motor that pumps blood throughout our body. This motor also needs blood to function properly, right? Yes, there is a separate network of blood vessels that supply blood to the heart itself. We call these the coronary arteries.

Sometimes, things like oil and cholesterol build up inside these arteries, like a cork in a water pipe, and deposits called 'plaque' form . Then these blood vessels become narrow, and sometimes even completely blocked. When this happens, some parts of the heart do not get the blood they need. We call this condition 'ischemia' .

So, what a bypass surgery does is to create a new route for the blood to bypass this blocked blood vessel, a 'bypass' route . This allows blood to flow properly to the affected part of the heart again.

What happens before the surgery?

Since this is a major surgery, it cannot be done all at once. Before that, several tests will be done to get a better understanding of your physical health. They will also prepare you mentally and physically for the surgery.

Preoperative tests

Several tests can be done to confirm whether this surgery is suitable for you and safe.

Informing you

Your doctor and hospital staff will talk to you and explain the following:

• Medications you are taking: You will be told which medications you need to continue taking and which medications you need to stop taking before surgery.
• Preparing for surgery: You will be told many things, such as a special soap to use before the surgery, whether someone will be available to help at home, and what to eat and drink.
• After surgery: You will be informed in advance about the recovery time, how you will feel, and what symptoms to watch out for.

What happens during the surgery?

This is a complex surgery that takes several hours. These are the steps that are usually followed.

1. Anesthesia and life support: First, you will be put completely to sleep. So you won't feel any pain. Then, your breathing will be connected to a ventilator . Also, IV lines will be inserted to give you medications and fluids.

2. Heart-lung bypass machine: Often, this machine temporarily takes over the work of the heart and lungs during surgery. This allows doctors to stop the heart and perform the surgery very smoothly without moving it.

3. Taking a blood vessel for the 'bypass': To create that new path, a section of healthy blood vessel is taken from somewhere else in your own body. This is usually taken from your leg, arm, or the inside of your chest . Depending on the number of blocked vessels (e.g. 2, 3, 4), several of these bypasses may be done. We call them double, triple, or quadruple bypasses.

4. Surgery: The surgeon makes an incision in the middle of the chest to access the heart. The piece of blood vessel that was removed is then connected to the main artery that carries blood out of the heart (the aorta) and to another blood vessel below the blockage. It's like building a new road across the blocked road.

5. Completion of the surgery: After the bypass is done, the heart is restarted, the chest bone is reattached with wires, and the incision is sewn up.

Different methods of surgery

Not everyone has the same type of surgery. Depending on your situation, different methods can be used.

What happens after the surgery?

After the surgery, you will be admitted to the Intensive Care Unit (ICU) . Specially trained staff will take good care of you. Once your condition is stable, you will be transferred to a regular ward. You will usually stay in the hospital for about 8-12 days.

After you go home, many people are asked to participate in a cardiac rehabilitation program . This is very important. Here, doctors, nurses, exercise instructors, and nutritionists work together to help you get back to being strong and healthy.

What are the benefits and risks of this surgery?

Advantages:

• Long-term success: This is a surgery that has been performed successfully for decades.
• Best Solution: This is often the best solution for people with multiple blocked blood vessels.
• Less need for retreatment: When bypass surgery is performed, the risk of the problem recurring is lower than with some other treatments (e.g., stent placement).

Risks:

This is a major surgery, so there are some risks. But most of these are preventable and treatable.

• Heart rhythm irregularities (Arrhythmias): Can occur after surgery and are often temporary.
• Bleeding: A potential risk of any surgery.
• Infections: These are very rare now, but you should be aware of symptoms like fever and chills.
• Effects on kidneys: May occur.
• Confusion: This can occur for a few days after surgery, especially in the elderly.

What to do in an emergency?

If you experience any of these symptoms while you are at home, you should go to a hospital's Emergency Department (ETU) immediately .

• Chest pain
• Difficulty breathing
• Dizziness (vertigo) or fainting
• Loss of consciousness
• Palpitations (feeling like your heart is beating fast)
• One side of the face drooping, one side of the body losing its strength
• Difficulty speaking
• Fever or chills

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