Shunting the heart - what it is and how it can help - important questions for people who have coronary heart disease . With such a disease, this operation can be the only hope for a full-fledged activity.
Heart bypass - what is this operation?
About 45 years ago, no one had a question: shunting the heart - what is it and what is it doing? The first developments in this direction, undertaken by the Soviet scientist-cardiac surgeon Kolesov VI, were subjected to doubts and even persecutions. The scientist's suggestion that with the help of a shunt it is possible to create a workaround to replace the vessels affected by atherosclerosis seemed fantastic. Aortocoronary heart bypass surgery now saves tens of thousands of lives every year. The operations are popular and effective, therefore they are conducted in many countries of the world.
Understanding the question: shunting the heart - for what and what it is, one should take into account its purpose. The operation is used for diseases that damage the blood vessels and violate the blood flow. The essence of the intervention lies in the creation of a new path of blood flow, which will replace the affected part of the vessel. For this purpose, shunts made from the veins of the patient or arteries are used. Shunts from veins are easier to create, however they are less reliable and can be closed a month after the operation. It is better to use arterial shunts, but this operation is more technical and not always possible.
Coronary bypass - indications
Cholesterol deposits on the walls of the vessels lead to a decrease in the lumen of the vessel. As a result, blood comes to the organs in insufficient quantities. If the lumen of the cardiac muscle vessel is narrowed, it can cause angina and myocardial infarction. To expand the lumen of the vessels, drug therapy, coronary angioplasty, and stenting are used. If the situation is difficult, cardiac surgeons can resort to surgery. Aortocoronary bypass grafting is indicated in such cases:
- severe angina, in which the patient is unable to serve himself;
- problems with multiple coronary vessels simultaneously (more than three);
- the narrowing of the coronary vessels exceeds 75%;
- combination of atherosclerosis with cardiac aneurysm .
Why is it dangerous to bypass the heart?
Along with the question: shunting the heart, what it is, there is often a question about the safety of this method. When surgeon cardiologists are asked whether it is dangerous to bypass the heart, they respond that it is not more dangerous than other operations. Although this type of surgical intervention is complex, modern advances in medicine and technology make it possible to perform it as safely as possible. In the postoperative period, the risk of complications increases in patients with such co-morbidities:
- excess weight;
- diabetes;
- high level of harmful cholesterol;
- high blood pressure;
- serious kidney disease.
Depending on the quality of the operation performed and overall health, complications can occur occasionally: swelling and redness at the seam, bleeding, heart attacks. Very rare, but possible complications include:
- pericarditis - an inflammatory process on the serous membrane of the heart;
- failures in the heart rhythm;
- acute heart failure;
- phlebitis - inflammation of the walls of the vein;
- stroke;
- Pleuritis - inflammation of the pleura of the lung;
- a decrease in the lumen in the shunt.
Heart bypass - how many live after the operation?
Patients who underwent heart surgery are always interested in how many live after cardiac bypass surgery. Doctors-cardiac surgeons call the average figure of 15 years, but specify that in the future everything depends on the patient and his state of health. With a qualitative shunt and compliance with all recommendations, the patient can live another 20-25 years. After this, the coronary bypass of the heart may again be required.
How is heart bypass done?
Before the operation, the patient is euthanized, a tube is placed in the trachea to control breathing, and a probe is placed in the stomach to avoid casting of gastric contents into the lungs.
Further on the stages of coronary bypass:
- The chest is opened.
- In an operation on an idle heart, an artificial blood circulation is connected, and when it is working, a bypass region is fixed.
- Take a vessel that will serve as a shunt.
- One edge of the vessel is connected to the aorta, the other to the coronary artery below the affected area.
- Check the quality of the shunt.
- Turn off the device of artificial circulation.
- Sew the thorax.
Coronary bypass in the heart
Coronary artery bypass grafts are an operation that involves complex and prolonged operations. Most of these operations are performed on a non-functioning heart with the use of an artificial circulatory system. This method is considered safer and more acceptable than open-heart surgery, but it increases the risk of complications. Use of the device may cause such negative reactions of the body:
- pulmonary edema;
- hematological problems;
- embolism of the kidneys and vessels of the brain;
- lack of oxygen for the work of organs.
Aortocoronary bypass surgery on a working heart
Aortocoronary bypass without artificial circulation allows avoiding complications caused by the use of a medical device. Operation on the beating heart requires a deep knowledge and skill from the surgeon. The shunting of the coronary arteries is carried out in physiological conditions for the heart, which reduces the risk of postoperative complications, accelerates the recovery and discharge of the patient from the hospital.
Coronary bypass without thoracic opening
Endoscopic cardiac bypass surgery is performed without compromising the integrity of the chest. These operations are more modern and safe and are common in European clinics. After such an operation, the wound is quickly healed and the body is restored. The essence of the method is to perform surgical intervention through small incisions in the thorax. To carry out such an operation, a special medical technique is needed that allows precise manipulation within the human body.
Rehabilitation after cardiac bypass surgery
Telling about: shunting the heart, what it is, the doctors immediately affect the moment of rehabilitation, on which the recovery rate of the patient depends.
Rehabilitation after cardiac bypass involves a set of exercises and activities:
- Breathing exercises. Performed from the first days after the operation. Exercises help to restore lung function.
- Physical exercise. Begin with a few steps in the ward during the first postoperative days and gradually become more complicated.
- Inhalation with the help of a nebulizer with the addition of bronchodilators or mucolytics.
- Intravenous laser or ozone therapy.
- Different kinds of massage.
- Ultravonotrophy with Pantovegin or Lidase.
- Magnetotherapy for the impact on peripheral parts.
- Dry carbonic baths.
Coronary artery bypass grafts - postoperative period
After the operation on the heart, the patient is carefully monitored for 2-3 months. The patient can remain in the intensive care unit for the first 10 days, which depends on the speed of recovery, well-being and absence of complications. In the period when anesthesia is in effect, the patient is fixed by limbs to avoid sudden dangerous movements. The first hours after surgery the patient can breathe with the help of the device, which is switched off by the end of the first day.
In the hospital, the joints are processed every day and their condition is monitored. A little pain, redness and a feeling of skin tightness at the seam site are normal for this period. If coronary artery bypass graft surgery was successful, then on the 7-8th day the patient is removed from the sutures. Only after this the patient can be allowed to take a shower. To facilitate the healing of the bones of the sternum, the patient is recommended to wear a corset for six months, sleeping during this period is possible only on the back.
Life after coronary bypass surgery
Coronary artery bypass grafting is considered successful if the patient returns to the usual mode of life two months later.
Duration and quality of life will depend on compliance with the prescription of the doctor:
- Take medication prescribed by a doctor and do not self-medicate.
- Do not smoke.
- Adhere to the recommended diet.
- After the operation of shunting, and then once a year undergo treatment in a sanatorium.
- Perform the feasible exercise, avoiding overload.
Diet after cardiac bypass surgery
In the postoperative period, patients who underwent coronary artery bypass grafting should carefully monitor their diet. On this factor, it depends how many years of life they can still live. The diet should be designed in such a way as to prevent the appearance of excess weight and the deposition of harmful cholesterol on the walls of the vessels.
After surgery, patients are advised to follow such advice:
- Reduce the amount of sugar, replacing it with stevia.
- Dairy products must be low-fat.
- From cheeses it is necessary to give preference to dietary cheeses and tofu.
- From meat, soy meat, white chicken, turkey, and low-fat veal are allowed.
- Cereals can be anything but manga and rice.
- In addition, use fish oil.
- From fish, you can eat low-fat and sometimes medium-fat fish.
- Of fats, it is desirable to give up all but vegetable virgin olive oil cold pressed.
- It is recommended to reduce the amount of salt.
- It is useful to eat fresh vegetables and fruits.
Approximate daily menu
- Breakfast - egg omelet made from whites, a salad of fruit and fat-free yogurt.
- The second breakfast is fat-free cottage cheese.
- Lunch is vegetarian soup with black dried bread, vegetable stew.
- Snack - baked apples.
- Supper - pancakes from vegetables, stewed fish of low-fat varieties or white chicken meat.