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By-pass surgery of heart

A by-pass surgery is a procedure where you open the chest and sew into one or more vessels, taken from elsewhere on the body, so that blood can be led by the narrow sections.

Narrow coronary arteries?

The heart is a powerful muscle that pumps blood around the body. To accomplish pump job requires heart constantly supply of oxygen (oxygen) and other nutrients. This supply comes from the blood through the blood vessels located outside the heart, coronary arteries (coronary arteries). There are three major coronary arteries. They provide various areas of the heart with blood. Each artery divides into small veins to the heart muscle gets good supply of oxygen and nutrients.

Angina pectoris
As we get older, the blood vessels become narrower due to deposition of fatty materials on the inside of the vessel wall, atherosclerosis . It also applies to the coronary arteries. A narrow artery can cause lack of oxygen in the tissue that the artery supplies (see figure ). When the heart's pumping frequency increases, ie by increasing heart rate, cardiac muscle requires increased blood flow to satisfy the need for oxygen. When it has developed stenosis in the coronary arteries, the veins eventually become so narrow that they are unable to supply the increased demand. This causes a lack of oxygen which results in pain. This chest pain that is caused by lack of oxygen in parts of the heart muscle called angina pectoris . Typically, this pain arises by pulse increase, mostly due to increased physical activity, but also stress can increase heart rate and thereby trigger angina attacks.

By total blockage of coronary artery loses a portion of the heart muscle blood flow, which leads to this section of muscle tissue dies. This is called a heart attack , or sore at heart.

By-pass surgery
By angina pectoris or acute myocardial infarction, it is usually performed coronary angiography , ie making an x-ray examination of the coronary arteries. Upon detection of the narrow portions or total block of one or more of the coronary arteries will be in the same session attempt to make percutaneous coronary intervention (PCI) . If PCI recognized a thin plastic tube (catheter) into the narrow portion, and is expanded artery using a balloon catheter (see figure ). Sometimes you do not let this be done, it could be for technical reasons or because there is more narrow portions of the paddle. When is it appropriate to do by-pass operation (see figure ). It is a procedure where you open the chest and sew into one or more vessels, taken from elsewhere on the body, so that blood can be led by the narrow sections.

The operation
A by-pass surgery is a major procedure that takes place under general anesthesia and connected to so-called heart-lung machine. Breastbone is divided in two so sternum and ribs can be folded to the side to get to the heart. During the procedure, it is common that two surgeons work together. A column chest and get ready for the by-pass surgery, while the other operates out a vein from the leg and make this ready for use on the heart. Then collaborating surgeons to sew the new blood vessels into the main artery (aorta) and into the coronary artery beyond the stricture. In many cases it is necessary to have 3-4 such new vessels. During the part of the operation where the new blood vessels are sewn in place stopped heart, and it is heart-lung machine which ensures circulation of the patient.

After the operation
It is common with ca. 1 week in hospital after surgery. It is also common to recommend training in the so-called cardiovascular training group, and it takes a few months before you're back in good shape. Due to the splitting of the sternum must include not charge arms the first 6-8 weeks after the procedure.

To prevent the vessels become narrow again, you will need to use blood thinning medications (aspirin) life. Most recommended also called beta blockers during the first year after surgery and almost all treated with cholesterol-lowering drugs to prevent relapse. And not least, smoking cessation, healthy diet and exercise is of utmost importance to ensure a good outcome in the long term.

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