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Treatment

 
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PostPosted: Mon Mar 27, 2006 12:21 pm    Post subject: Treatment  Reply with quote

The aim of coronary bypass surgery is to bypass (get around) the narrowed sections of coronary arteries. The heart surgeon does this by grafting a blood vessel between the aorta (the main artery leaving the heart) and a point in the coronary artery beyond the narrowed or blocked area
Doctors can carry out a bypass graft for each of the main coronary arteries affected. Most people have three, four or sometimes more grafts as the surgeon tries to do as thorough a job as possible to make sure that the operation lasts. In most cases at least one of the blood vessels used for the grafts is made using an artery from inside the chest called the internal mammary artery. (The left and right internal mammary arteries supply blood to the breastbones but this area does also have other sources of blood supply.) The internal mammary artery is less likely to narrow over time than a vein graft. Blood vessels from other parts of the body are used for the other grafts - usually from the leg or an artery in the arm, or both.

In most heart operations, the surgeon reaches the heart by making an incision (cut) down the middle of the breastbone. Just occasionally they may use a different approach.

Usually the surgeon uses a heart-lung machine to circulate blood around the body while operating on the heart. In some cases the surgeon may be able to operate on the coronary arteries while the heart is beating, without needing to use a heart-lung machine. But there is always a machine available in the operating theatre in case it is needed.

While the heart-lung machine is doing the work of your heart and lungs, the surgeon can temporarily stop your heart with potassium, or stop its rhythmical beating electrically. The heart starts to beat again as soon as the blood supply is restored.

After the operation, you will have a scar down the length of your breastbone. You are bound to feel discomfort in your chest immediately after surgery, but this usually eases off over the next few weeks. If a vein has been removed from your leg, you will also have some discomfort and swelling there. Most patients are sitting out of bed a day or two after the operation and return home in about a week.

How successful is the operation?

Between six and nine in every ten patients who have a bypass operation get immediate relief from angina, lasting for at least five years. Most of the others find that the bypass improves their angina.

However, the bypass operation does not affect the cause of atheroma. So your angina may return if the atheroma builds up inside the graft. This is more likely to happen if you carry on smoking, or donÕt control your blood pressure or cholesterol. Narrowing of the graft happens in about 1 in every 20 patients each year. If the angina does come back, you will probably need to have another coronary angiogram and, depending on the results, you may be advised to take medicines, or have an angioplasty (see page 9) or another heart operation.

Over 28,000 patients have coronary artery bypass surgery in the UK each year. The risk of dying within a month of a first operation is low Š about 2 or 3 in every 100 patients. This is the same level of risk as for a major operation on the abdomen.

Keyhole coronary surgery

Instead of using a full incision (cut) through the breastbone, some heart operations can be carried out through smaller and more limited 'keyhole' incisions. Keyhole surgery is only used in special circumstances. It is not suitable for all patients because the surgeon usually needs access to get to all sides of the heart to do the three, four or more grafts that are needed.

Port access surgery

This involves making a series of small incisions (cuts) in the chest. The surgeon then operates using a viewing telescope and special catheters. A specially adapted heart-lung machine takes over the work of the heart and lungs while the surgeon carries out the bypass surgery.

Beating heart surgery

In some centres heart bypass operations are carried out while the heart is still beating, with doctors getting access to the heart through a full chest incision (cut). This means that the doctors do not need to use a heart-lung bypass machine. The results of long-term trials of this procedure have so far been good but more research is needed.
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dpfocjames
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PostPosted: Mon Oct 08, 2012 11:59 am    Post subject: Reply with quote

Coronary bypass surgery is a procedure that restores blood flow to your heart muscle by diverting the flow of blood around a section of a blocked artery in your heart. Coronary bypass surgery uses a healthy blood vessel taken from your leg, arm, chest or abdomen and connects it to the other arteries in your heart so that blood is bypassed around the diseased or blocked area.
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jameshopes
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PostPosted: Fri Dec 07, 2012 8:21 am    Post subject: Reply with quote

Physiotherapy is best suitable after bypass surgery.You can do physiotherapy on advice of doctor  which will help you to return back to the normal life.
Grafting physiotherapy is advised after surgery which is related to breathing.


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