Shunting the heart. Shunting the heart after a heart attack. Heart bypass: patient feedback

Aorto-coronary bypass surgery (CABG) is an operation that is prescribed in the case of coronary heart disease. The narrowing of the lumen of the arteries supplying the heart with blood (stenosis), resulting from the formation of atherosclerotic plaques in them, is fraught with serious consequences for the patient. When the blood supply to the heart muscle is disturbed, the myocardium is inferior to the amount of blood necessary for normal functioning, which eventually leads to its damage and weakening. In this case, during physical activity, a person experiences angina pectoris (pain behind the sternum).

The most common pathology among all heart diseases is ischemic heart disease (IHD). She spares neither women nor men. Lack of blood supply can lead to the necrosis of a part of the heart muscle - myocardial infarction, which threatens the very serious complications, even death. Shunting the heart after a heart attack in order to eliminate its consequences, for the prevention of heart attack, as well as for other clinical forms of IHD, is prescribed if, with the help of conservative treatment, the positive effect was not achieved. This is the most radical, but the most adequate method of restoring blood flow. In this article we will tell you what constitutes aortocoronary bypass of the heart and how to prepare for it.

What is the operation?

CABG can occur with multiple or single lesions of the arteries. During the operation, in those vessels where the blood flow is disturbed, shunts are created - bypasses. This is done by attaching healthy arteries to the coronary arteries. As a result, the blood flow should bypass the place of blockage or stenosis. Bypassing the heart, thus, allows a full supply of blood to the heart muscle.

Preparing for an operation

No less important for the success of CABG than the professionalism of the team of surgeons, has a positive attitude of the person to a favorable outcome of treatment. This operation is not more dangerous than other types of surgical interventions, but it requires preliminary careful preparation. First, as well as before any cardiosurgery, the patient is referred for examination, which consists of ECG, ultrasound, laboratory tests and analyzes, as well as an assessment of the general condition. You will also need to make angiography (tickoronography). This diagnostic procedure makes it possible to determine the condition of the arteries feeding the heart muscle, to reveal the exact place of the formation of the plaque and the degree of constriction. Carry out a study using X-ray equipment (an X-ray contrast substance is injected into the vessels and then take a picture).

Part of the diagnostic measures are performed in a hospital, part - outpatient. A person is usually put in a hospital one week before the operation, and at the same time careful preparation begins. One of its important stages is the development of a special breathing technique, which will later come in handy.

Operation

As already mentioned, coronary artery bypass grafting is carried out with the purpose of creating an additional bypass path with the aid of a shunt from the aorta to the artery, which will allow to pass through the clogged area and restore blood flow. Most often, the shunt becomes the thoracic artery, because it has good resistance to atherosclerosis due to its unique characteristics and has durability as a shunt. In some cases, use the radial artery or the subcutaneous vein of the thigh.

Heart bypass can be single, double, triple and so on. It depends on how many coronary vessels there is constriction. By the way, this does not depend on the degree of manifestation of the disease. Thus, a patient with severe coronary artery disease may require the imposition of only one shunt, and a person whose pathology is less likely to have two or even three. The operation is performed on the open heart under general anesthesia, depending on the level of difficulty it can last three to six hours.

Three types of CABG

1. Using the apparatus of artificial circulation. If this option is used, then the patient's heart is stopped.
2. At the working heart. This method allows you to complete the operation more quickly and reduces the likelihood of complications, but requires the presence of surgeons a lot of experience.
3. Minimally invasive (with or without an artificial circulation device). This is a relatively new technique, which makes it possible to reduce blood loss during the intervention, to reduce the risk of infectious complications. After such a CABG, the patient quickly recovers, the time spent in the hospital is reduced to five to ten days.

It must be said that any heart surgery carries certain risks. However, thanks to modern equipment, sophisticated technology and wide application practice, they can be minimized. Cardiac bypass is very good in terms of positive results. Comments of most people who underwent such an operation are imbued with words of gratitude to doctors. And yet the prognosis depends on the individual characteristics of the patient and the clinical picture of the disease.

Postoperative period

Immediately after surgery, a person is in intensive care, it is there that the primary recovery of the lungs and heart muscle begins. It is very important that at this time the operated correctly breathe. The period of stay in intensive care can be up to ten days, it depends on how the heart was bypassed. Rehabilitation also begins in a hospital, and then continues in a rehabilitation center. The seams on the chest and where they took the material for the shunt, are washed with antiseptics to avoid decay and contamination. They are taken off somewhere on the seventh day, if the wounds have successfully healed.

Rehabilitation

In places where there were stitches, for a while, pain and burning will be felt. When the wounds are somewhat delayed (after one or two weeks), the patient is allowed to take a shower. It will take more time to heal the bone of the sternum - four to six months. You can wear a chest bandage to speed up this process. In the first four to seven weeks on the legs, you must wear special elastic stockings to avoid swelling. At this time, you should take care of yourself from intense physical exertion.

Due to blood loss, which occurred during the operation, a person may develop anemia. However, no special treatment is required in this case. It is enough just to follow a diet based on the consumption of foods containing a large amount of iron, and a month later the hemoglobin level will return to normal. The patient will have to make efforts to restore normal breathing. To do this, perform special breathing exercises, which he was taught before surgery. Also with their help you can avoid pneumonia.

After a shunting of the heart, a cough is observed. Do not be afraid of this. Coughing is the most important part of rehabilitation. It can be eased by pressing the palm or the ball against the chest. Frequent changes in the position of the body will speed up the healing process. Doctors usually explain how to turn and in what cases it is necessary.

Rehabilitation is accompanied by a gradual increase in physical activity. When the patient stops angina attacks, he is given the required motor regimen. First, people are allowed to walk a short distance (a day to one kilometer) along the hospital corridor, then gradually the loads increase, and after a while almost all restrictions are removed.

After discharge

People who have undergone heart bypass surgery are recommended to visit the sanatorium after the end of inpatient treatment. After a lapse of one and a half to two months, you can return to work. At the same time, a stress test should be performed to assess the patency of the superimposed shunts and see how well the oxygen supply to the heart is. If there are no changes on the ECG, the patient does not experience painful sensations during the testing, which means that the restoration can be considered successful.

Heart bypass: price

The operation is high-tech, therefore it has a high enough cost, which depends on the required number of shunts, the mode of intervention, the current state of the patient's health, the degree of comfort that will be provided after CABG. Another important price criterion is the level of the clinic where cardiac bypass surgery will be performed. Of course, it will be cheaper to perform an operation in a conventional cardiological hospital than in a specialized private clinic. On average, in Moscow, the cost of CAB varies between 150-500 thousand rubles, in Israel - 23-30 thousand dollars, in clinics in Germany the price for this operation starts from 25 thousand euros.

Heart bypass: patient feedback

Many people note that recovery after CABG is difficult. Patients experience difficulty breathing, especially at night. Some say that for a while they were forced to sleep half-sitting. But after a while, people cease to feel pain behind the breastbone, somewhere in a month there is a significant improvement in the state, such dynamics continue. Patients who underwent surgery a few years ago are said to feel good, along with healthy ones. Some complain that they had to reconsider their way of life, stop smoking, and follow a diet. But generally, to abandon bad habits should be followed by all people, and not only those who underwent heart surgery.

Finally

In certain cases, only surgery can save lives. A heart bypass done in time can prevent a heart attack and its serious consequences, return the person to a full-fledged activity. Be healthy!