Wednesday, April 10, 2024

Recovery From Heart Bypass Surgery

A Better Approach To Cardiac Bypass Surgery: Less Pain Less Risk And Less Recovery Time

WATCH Triple Bypass Open Heart Surgery

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Learning you need cardiac bypass surgery can be worrisome. Fortunately, Miami Cardiac & Vascular Institute offers a minimally invasive approach to this procedure, eliminating the need to cut open your chest or stop your heart, and greatly reducing pain and recovery time.

Even better, the Institutes chief of cardiac surgery, Joseph McGinn Jr., M.D., is internationally recognized for pioneering this minimally invasive coronary artery bypass graft surgery. Known as the McGinn Technique, the innovative surgery is currently performed routinely in only a handful of American hospitals, but is likely to become tomorrows standard of care, he says.

This blows away regular surgery, Dr. McGinn says. Eventually, it is going to be part of every surgeons repertoire.

When You Need Bypass Surgery

Coronary artery bypass surgery is a procedure used to treat the narrowing of the arteries that supply oxygen and nutrients to the heart. Cardiologists may recommend bypass surgery if coronary arteries are so narrowed or blocked that you run a high risk of a heart attack.

Joseph McGinn, Jr., M.D., chief of Cardiac Surgery at Miami Cardiac & Vascular Institute.

Evolving Science

Is The Minimally Invasive Approach For You?

How It Works

The traditional approach to bypass surgery can be grueling for patients, who often endure considerable pain and a recovery time of three months or longer.

What You Need To Know

Caring For Your Wound

The metal wires holding your breastbone together are permanent.

But the stitches closing your skin will gradually dissolve over the weeks following surgery as your skin heals.

While you’re recovering in hospital, you’ll be told about how to care for your wounds at home.

It’s important to keep the wounds clean and protect them from the sun while they’re healing.

You’ll have a scar where the surgeon cut down your chest, as well as where the grafted blood vessel was taken from.

These will be red at first, but will gradually fade over time.

How Do I Manage Post

A cardiac anesthesiologist is also a pain management specialist for conditions related to surgery. Your anesthesiologist will talk to you about your options for managing post-operative pain. Before your surgery, the anesthesiologist may ask about your pain tolerance to help gauge how best to manage your post-operative pain, guiding decisions such as the proper narcotics dosage, the feasibility of nonnarcotic pain medication options, and the need for nerve blocks.

Although most heart surgeries are major surgeries, they are typically not a source of long-term pain. Even in the short term, the pain may be less severe than with operations on other areas of the body. Opioids are used when necessary, but there are many other pain management options, including:

  • Lidocaine infusion

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What Are Some Types Of Heart Surgery

There are many types of heart surgery. The National Heart, Lung, and Blood Institute, which is part of the National Institutes of Health, lists the following as among the most common coronary surgical procedures.

In addition to these surgeries, a minimally invasive alternative to open-heart surgery that is becoming more common is transcatheter structural heart surgery. This involves guiding a long, thin, flexible tube called a catheter to your heart through blood vessels that can be accessed from the groin, thigh, abdomen, chest, neck, or collarbone. A small incision is necessary. This type of surgery includes transcatheter aortic valve implantation to replace a faulty aortic valve with a valve made from animal tissue, MitraClip® placement for mitral valve abnormalities, and WATCHMAN® placement for nonvalvular atrial fibrillation patients.

Eat Healthy But Don’t Diet

Life Support is NOT pretty. This is after my second open heart surgery ...

Dr. Rawn: You shouldn’t be dieting before heart surgery. You will do much better if you come nutritionally prepared by having eaten adequate protein to build muscle. Healing requires calories, and when people are very stressed, their body tends to break down muscle for energy. I tell patients’ families to bring them their favorite foods, just so they can consume the calories they need to heal and have energy.

Dr. Bolman: Obesity is an underlying reason why many people need CABG, but giving up sugar before heart surgery is not necessary. Long-term changes in diet and eating habits can be discussed later.

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Who Will Help Perform The Bypass Surgery

Throughout the surgery, several types of specialists ensure the procedure is performed properly. A perfusion technologist works with the cardiopulmonary bypass machine.

A cardiovascular surgeon performs the procedure and an anesthesiologist ensures anesthesia is delivered to your body properly to keep you unconscious during the procedure.

Imaging specialists may also be present to take X-rays or help ensure that the team can view the site of the surgery and the tissues around it.

When you wake up from heart bypass surgery, youll have a tube in your mouth. You may also feel pain or have side effects from the procedure, including:

  • pain at the incision site
  • pain with deep breaths
  • pain with coughing

Youll likely be in the ICU for one to two days so your vital signs can be monitored. Once youre stable, youll be moved to another room. Be prepared to stay in the hospital for several days.

Before you leave the hospital, your medical team will give you instructions on how to care for yourself, including:

  • caring for your incision wounds
  • getting plenty of rest
  • refraining from heavy lifting

Even without complications, recovery from heart bypass surgery can take 6 to 12 weeks. Thats the least amount of time it takes for your breastbone to heal.

During this time, you should avoid heavy exertion. Follow your doctors orders regarding physical activity. Also, you shouldnt drive until you get approval from your doctor.

  • fever over 100.4°F
  • increasing pain in your chest
  • rapid heart rate

After You Leave The Hospital:

  • Make sure you have someone to drive you home from the hospital. For a while, you will also need some help at home.
  • You will probably have your stitches or staples removed in a follow-up appointment in 7 to 10 days. Be sure to keep all follow-up appointments.
  • You may still tire easily, but you will gradually start to recover your strength. It may be several weeks before you fully recover.
  • Do not drive until your healthcare provider says it is safe for you to do so.
  • Avoid lifting anything heavy for several weeks.
  • Follow all the instructions your healthcare provider gives you for medicines, exercise, diet, and wound care.
  • Your healthcare provider may refer you to a cardiac rehab program to help in rebuilding your strength after surgery.

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Coronary Artery Bypass Surgery

  • Once your doctor has opened the chest, he or she will stabilize the area around the artery to be bypassed with a special instrument.

  • The rest of the heart will continue to function and pump blood through the body.

  • The heart-lung bypass machine and the person who runs it may be kept on stand-by just in case the procedure need to be completed on bypass.

  • The doctor will do the bypass graft procedure by sewing one end of a section of vein over a tiny opening made in the aorta, and the other end over a tiny opening made in the coronary artery just below the blockage.

  • You may have more than one bypass graft done, depending on how many blockages you have and where they are located.

  • Before the chest is closed, the doctor will closely examine the grafts to make sure they are working.

  • What Happens During This Procedure

    What does recovery from bypass surgery look like?

    CABG is a complicated procedure that takes several hours to complete . The following steps happen for most of these surgeries.

    Anesthesia and life support

    Like most major surgeries, the first step to this surgery is to put you into a state of deep sleep. This keeps you from feeling pain during the surgery. It also helps relax you for other steps in the preparation.

    Because CABG involves work on your heart, it usually involves multiple types of life support. These include:

    Blood vessel harvesting

    CABG involves creating a bypass for blood to use to reach blocked areas of your heart. A bypass is like a detour for your blood to use to get around an obstacle. Creating that bypass involves taking a blood vessel from somewhere else in your body, such as your leg, arm or chest, and using it to craft the detour around the blockage. In cases where theres more than one blocked artery, multiple bypasses may be necessary. These are double , triple and quadruple bypasses.

    Surgery

    To reach your heart to perform the surgery, a cardiothoracic surgeon will make an incision in the center of your chest. Theyll also split your breastbone down the middle, then spread and lift your rib cage to make it easier to access your heart.

    Once the bypass is in place, the surgeon can restart your heart and get your blood flowing again. Theyll then lower your rib cage back into place and wire it together so it can heal. Theyll then close the incision in your chest with staples and sutures .

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    What Are The Risks Of Coronary Artery Bypass Surgery

    Possible risks of coronary artery bypass graft surgery include:

    • Bleeding during or after the surgery

    • Blood clots that can cause heart attack, stroke, or lung problems

    • Infection at the incision site

    • Failure of the graft

    There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor before the procedure.

    What Is Heart Bypass Surgery

    A heart bypass procedure involves attaching a blood vessel taken from elsewhere in the body to the diseased coronary artery. This results in a redirection of the blood flow around the blockage. When a person has a double bypass surgery, it means that two or three arterial blockages are rerouted.

    Heart bypass surgery is done as an inpatient procedure. It’s often a planned procedure, but in some instances, an emergency heart bypass procedure is performed after a person has a heart attack.

    Heart bypass surgery may sometimes be performed on infants and children, but not for the same reason adults have the procedure done. Rather, infants and children would be more likely to need heart bypass surgery because of congenital heart disease.

    The steps involved in a traditional open method of heart bypass surgery include:

  • The anesthesiologist administers medication to induce unconsciousness so that your surgery is pain-free.
  • The surgeon will make an incision in the middle of the chest and the breastbone is separated to allow for an opening to perform the surgery.
  • You may be connected to a machine called a cardiopulmonary bypass pump , sometimes called a heart-lung bypass machine, which takes over the function of the heartwhile your heart is stoppedso that the surgeon can perform the procedure.
  • Depending on how many blocked arteries you have, the surgeon may perform more than one coronary artery bypass procedure during the same surgery.
  • Verywell / Tim Liedtke

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    Ways To Speed Up Recovery After Surgery

    We all know that surgeons are very precise and that surgical procedures have come a long way over the years, but the truth is, youre still having a knife making a hole in your body for whatever reason. While these incisions are sometimes small, the human body still need time to recoup.

    Whether youre in for an extended hospital stay or at home, you should be prepared to work for your recovery following the procedure and depending on what it was for, the procedure can impact how much time your body needs to get back to normal. Here are 12 tips to bounce back quicker after going under the knife

    What To Expect On The Day Of Surgery

    25 Elegant Open Heart Surgery Recovery Time

    General anesthesia is started right before the surgical procedure. Then the cardiothoracic surgeon starts harvesting veins from the legs or arms. These vessels are used for bypass grafts.

    The surgical team will confirm that the vessels are healthy enough to be used to bypass the diseased coronary arteries. Meanwhile, the surgeon opens the chest and begins preparing the heart. They may also remove another vessel from the left chest, to supplement the other veins already harvested.

    During the vast majority of quadruple bypass surgeries, the heart is stopped to prevent motion. A heart-lung bypass machine is used to allow both the heart and lungs to be still.

    This helps the surgical team complete the graft portion of the surgery safely and quickly. The machine supplies oxygen to the blood instead of the lungs doing so. It pumps the oxygenated blood through the body as the heart would normally do.

    During surgery, the blood vessels are attached to the existing heart vessel, around the areas of blockage. It’s similar to a quick detour you might take to avoid traffic, with the blood literally rerouted around the blocked portion of the cardiac artery.

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    Nontraditional Coronary Artery Bypass Surgery

    Nontraditional coronary artery bypass surgery includes off-pump coronary artery bypass surgery and minimally invasive coronary artery bypass surgery.

    Off-Pump Coronary Artery Bypass Surgery

    Surgeons can use off-pump coronary artery bypass surgery to bypass any of the coronary arteries. Off-pump coronary artery bypass surgery is similar to traditional coronary artery bypass surgery because the chest bone is opened to access the heart.

    However, the heart isnt stopped and a heart-lung-bypass machine isnt used. Instead, the surgeon steadies the heart with a mechanical device.

    Off-pump coronary artery bypass surgery sometimes is called beating heart bypass grafting.

    Minimally Invasive Direct Coronary Artery Bypass Surgery

    There are several types of minimally invasive direct coronary artery bypass grafting. These types of surgery differ from traditional bypass surgery because the chest bone isnt opened to reach the heart. Also, a heart-lung bypass machine isnt always used for these procedures.

    Read Also: How Do They Do Heart Bypass Surgery

    The First Few Weeks At Home

    During the first few weeks after hospital discharge, many people who have undergone heart bypass surgery:

    • Experience low energy levels and feel fatigued frequently
    • Have intermittent post-operative pain
    • Need to continue taking pain medication, as ordered by the healthcare provider
    • Are not yet able to return to work
    • Have strict activity limitations such as a lifting and driving restrictions
    • May experience sadness and mood swings
    • Commonly have symptoms of major depression

    Coping During the First Few Weeks at Home

    You should rest often and sleep when you feel tired. Sleep will help your body recover and help to replenish your energy level. If you have trouble getting enough sleep at night, there are some things you can do to help, including:

    • Be sure to establish a regular pattern of going to bed and getting up at the same time every day.
    • If you have frequent insomnia, you may want to eliminate naps to ensure you are tired at night.
    • Take your pain pills before you go to bed
    • Be sure to sleep on your back for the first four to six weeks while your breastbone heals.

    Coping with Pain

    Pain after bypass surgery is common, some things you can do to relieve pain include:

    Important Activity Warning

    • Lifting objects that weigh over 10 lbs: This includes children, laundry baskets, trash receptacles and other objects.
    • Driving: Even a minor car crash could cause the chest area to slam into the steering wheel.

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    Heart Care Close To Home In Kansas

    Your heart care is important. To deliver personalized care, our cardiologists at Ascension Via Christi start by listening to understand you, your health history and your goals. We take the time to answer all your questions big and small. Remember to tell your doctor how you are feeling at each visit. By getting to know you, we deliver heart care thats right for you.

    Cardiologists specialize in diagnosing and treating heart diseases, including:

    • Atherosclerosis
    • High blood pressure, cholesterol and triglycerides
    • Pericardial disease

    From screenings and managing chronic heart conditions, to more advanced care, were here for you. With cardiologists and surgeons trained in the latest heart care testing, treatment and procedures, and as part of a national network, you have access to advanced heart care close to home.

    Physical Aspects Of Recovery

    Recovering from Open Heart Surgery

    The pace of your physical recovery will depend significantly on your health before you received bypass surgery. For example, if you had coronary artery disease but no other medical conditions, it will probably take you less time to resume a normal activity level than if you are older or have other medical conditions.

    Your recovery will take at least 4 to 6 weeks. During your recovery from CABG surgery, your life will probably be quite different from how it was before your surgery. The table below lists “normal” physical conditions after CABG surgery.

    During CABG surgery recovery
    • Not be able to concentrate.
    • Have good days and bad days.

    Also, limitations on your physical activity can leave you with few options to get out of the house and clear your head.

    You should be aware that these feelings of depression are common for people who have had major heart surgery. You may also feel lonely and envious of other people who are living their lives without the discomfort and pain that you are experiencing right now.

    Remember that you are going to start feeling better very soon. You are working to get back to your lifea life that may be more comfortable than before. Your new life is one with bypassed coronary arteries and more blood flowing to your heart. What this means for you is that you will not experience the chest pain, shortness of breath, or other symptoms that you had before.

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    The Day After Surgery

    You continue to be on a heart monitor and oxygen monitor. Your health care team helps you sit in a chair. Increasing activity helps your lungs and bowels regain normal function. As soon as the breathing tube is out, youre encouraged to drink and eat as soon as possible. Its a normal side effect of the anesthesia wearing off to feel nauseated or to not want to eat. Narcotic pain medication also can upset your stomach.

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