Aortic - coronary artery bypass surgery at Vinmec

This is an automatically translated article.

The article is professionally consulted by Master, Doctor Nguyen Xuan Thanh - Cardiovascular Center, Vinmec Times City International General Hospital.

Vinmec Times City Hospital would like to thank customers for their interest in learning about coronary artery bypass surgery. We would like to summarize the relevant information so that the patient has more information to prepare before, during and after surgery.

1. Aortic bypass surgery - What is coronary artery?

Aortic-coronary artery bypass surgery (or coronary artery bypass grafting for short) is a surgery to increase blood flow to the heart through the coronary system. Indicated for the treatment of stenosis - occlusion of one or more coronary arteries. The surgeon connects the stenosis with the patient's own artery as a graft to "bridge" (it can be a magnetic artery in the chest called the left and right internal thoracic arteries, the radial artery in the forearm) , veins in the thighs and legs) to help the coronary arteries recirculate. Patients after coronary artery bypass surgery can be physically active as before, and their quality of life is improved.

2. Why do coronary artery bypass graft surgery?

Your doctor will tell you when to have coronary bypass surgery or to use other alternatives to revascularization such as dilation and stenting. Coronary bypass surgery is an option if:
The patient has chest pain due to multiple coronary stenosis causing myocardial ischemia even with mild physical activity even at rest. The patient had multiple coronary artery stenosis and decreased left ventricular function. Patients with coronary artery stenosis or occlusion (the common trunk is the branch that supplies nearly the entire left ventricle). Patients with coronary artery lesions for which previous stenting failed or prior stenting but re-stenosis. Coronary artery bypass surgery is an emergency when the patient has a myocardial infarction and coronary intervention is difficult or failed. Surgery does not treat the cause of atherosclerosis, so even after surgery, patients still need to make active lifestyle changes, control risk factors such as quitting smoking, reducing smoking. weight ... and take medicine to treat underlying diseases such as hypertension , dyslipidemia , diabetes ...

3. What does the patient need to prepare for the surgery?

To prepare for the surgery, the patient will be given specific instructions by the doctor on the following issues:
Quit smoking for at least 1 month. Stop antiplatelet drugs 3-7 days before surgery depending on the antiplatelet drug the patient is taking. Patients need to be hospitalized 2 days before, do pre-operative tests such as X-rays, blood tests, ... It is necessary to arrange work to rest for about 4 to 6 weeks to recover after surgery. The patient/patient's family is explained about the disease, why surgery, risks, as well as instructions after surgery what to follow. The patient's family and patient sign a written commitment to surgery.

4. Steps to perform surgery:

Position: the patient lies on his back, his hands are down on his body (if the radial artery is taken, the hand side takes the pulse is transverse), with a small pillow behind the shoulder. Expose the leg area to remove the saphenous vein.
Anesthesia: endotracheal anesthesia. Place catheters for hemodynamic monitoring (arterial, central venous), lines, temperature probe.
Technique: Depending on each patient, the extent and number of damaged vessels... the surgeon can perform bypass surgery by two methods:
Surgery while the heart is still contracting. Surgery when the heart stops beating, blood flows through the artificial heart-lung machine.

5. Immediately after surgery

When performing surgery, the patient is under general anesthesia so the patient will not feel anything. After surgery, the patient continued to maintain anesthesia to transfer to the intensive care unit. Here the patient will be released from anesthesia and regain consciousness. Treatment is continued in the intensive care unit for a few days to wean off the ventilator, take heart support drugs, remove the drains...

6. Leaving the intensive care unit

When the patient's condition improves, the patient will be transferred from the intensive care unit to the regular ward. Here, the patient continues to receive stable treatment and rehabilitation until discharge, usually an additional 4-6 days. The recovery time continues for about 5 weeks and the patient will return to work, sports, driving...

7. Normal manifestations after surgery

After coronary artery bypass surgery, patients may experience symptoms including:
Discomfort or itching at the incision site. Swelling where the artery or vein was removed for grafting. Muscle pain or pain in the shoulders and upper back from lying down Fatigue, mood swings. Sleep problems or loss of appetite. Constipation . Chest pain around the thoracic surgery (more often with traditional surgery). Usually, these symptoms go away after 4-6 weeks.

8. Patient's life after coronary artery bypass surgery

Coronary artery bypass surgery improves blood flow to the heart, but it does not cure the cause of coronary artery disease, which is atherosclerotic plaque. Therefore, patients still need to continue taking medications to treat underlying diseases such as: drugs that prevent blood clots, blood lipid-lowering drugs, blood pressure-lowering drugs, diabetes drugs..., lifestyle changes. like:
Quit smoking. Eat less fat, reduce salt. Weight control. Exercise regularly. Reduce stress.

9. Advantages of coronary artery bypass surgery at Vinmec

Coronary artery bypass surgery helps create a new path for blood to bypass the narrowed artery to nourish the heart muscle. After coronary artery bypass surgery, about 95% of patients will reduce or completely relieve symptoms of chest pain; quickly recover health and can be physically active almost like a normal person.
Patients will reduce hospital stay, recover quickly after surgery and most avoid the harmful effects of extracorporeal circulation if too many stents have not been placed before or the disease has not progressed too seriously.
Vinmec Times City International General Hospital is equipped with a Hybrid Operating Room with state-of-the-art equipment such as DSA angiography machine, anesthesia machine with the most closely integrated patient hemodynamic monitoring software (system) PiCCO system, entropy,...). Therefore, the Hybrid operating room can meet the requirements of surgery and angioplasty, coronary stenting, aortic stent grafting, open heart surgery, heart valve replacement for congenital heart diseases with modern minimally invasive techniques. most invasive, safe, help patients recover health soon.
Furthermore, before undergoing coronary artery bypass graft surgery, the patient was thoroughly and carefully examined and probed with modern equipment: stress electrocardiogram, 4D echocardiogram, cardiac magnetic resonance, etc. 640-sequence computed tomography, PET-CT, coronary angiography with intravascular ultrasound, FFR, etc... by experienced professors and cardiologists.
The team of doctors performing surgery at Vinmec is experienced and highly qualified:
Master Doctor Nguyen Xuan Thanh has more than 10 years of experience in the field of cardiology. The doctor was former Vice Chairman of Cardiothoracic Surgery Department - Viet Tiep Hospital, currently a Cardiologist at Cardiovascular Center - Vinmec Times City International General Hospital.

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