How I live after bypass surgery a heart?
Cardiovascular diseases are leading causes of death among the working population and the elderly worldwide. Myocardial infarction, which is the direct cause of the death is the result of long-term process, in which blockage of the coronary arteries of the heart. As a result of scientific-technical progress, it has been possible to perform an operation CABG – coronary artery bypass grafting in patients with ischemic heart disease and a high risk of sudden death. How has the life expectancy of these patients after surgery?
Duration of life after different options for operative intervention on the heart have always been interested in both doctors and their patients. After all, any other operations do not carry this risk: the liver is restored, the person can live without one kidney. Stomach resection was sometimes removed most of it, you can live without a few meters of the intestine, without a portion of the pancreas and no gall bladder.
Many years can live a eunuch, and only the heart always remained a «stumbling block» surgeons: it cannot be subjected to resection, the heart can contract and perform its function only as a body. That is why surgeons have developed such operations, which allowed to keep the heart as an organ, but greatly improve its function. This operation (or, more precisely, several varieties of this operation) is called «heart bypass surgery».
What is CABG?
CABG (coronary artery or bypass grafting) is an operation in which the arterial blood is supplied «bypass» the narrowed vessel affected by atherosclerosis of the aorta. You need an «intermediate» vessel, which is called a shunt. It will be supplied blood by the affected places. The role of shunt used is the autograft, it has its own vessel: an artery or vein.
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On average, each operation coronary artery bypass surgery lasts from 3 to 4 hours. A significant part of this time is not to impose the anastomoses between the aorta, the shunt and the coronary vessels, and to take the autograft. In some cases, bypass surgery is performed on a beating heart. It’s an option: in this case, it is not necessary to use the services of a heart-lung machine, to enter the body in hypothermia and «stop heart».
Indications for surgery
The indication for such an operation is progressive angina, including post-infarction (otherwise known as «dumb»), in which myocardial ischemia is not accompanied by any pain. In this case, patients performed a preliminary study – computer contrast angiography of the coronary arteries. If myocardial ischemia develops in a small area of the vessel, which can be bypassed, then there are sufficient indications for surgery.
If struck by small branches, atherosclerotic stenosis carries a numerous nature, and coronary vessels affected diffuse, then the operation coronary artery bypass grafting is not shown, since it will be useless. This would resemble the attempt to carefully plug only one hole in through the leaky roof.
Often patients who need this surgery, ask the doctor: «how I live after this surgery»? People are concerned not for the fact that before the surgery, they have a very high risk of sudden death, and the fact that over the heart the doctor will produce any interference. It is a psychological rejection of the operation is well known to doctors. However, after heart surgery to restore coronary blood flow the prognosis is very favorable: if the only the narrowing of the coronary vessels, the risk of sudden death can be reduced to the average in the population for a given age. In other words, after coronary artery bypass surgery possible full recovery.
Rehabilitation after bypass surgery of heart vessels starts in the hospital. Early activation of the patient is required to ensure that the shunt worked well, and after it pumped the appropriate amount of blood. First, of course, the main tasks are the restoration of spontaneous breathing after removal of the patient from artificial ventilation of lungs. The next task should be to combat hypostatic pneumonia: the patient needs to train their lungs. Since autografts come from the patient or tibia (in the case of veins), or from vnutripuzarnogo space (in the case of the arterial shunt), you must heal these wounds.
Now, after careful ECG monitoring starts with activation of the patient. The criterion of the effectiveness of the operation is the absence of signs of myocardial ischemia at rest and with those loads under which it had previously identified.
Initially, the patient just walks in a hospital corridor, then on the floors, locking in the diary the time of loading. At the same time the patient is Holter monitoring.
The next stage of rehabilitation should be a Spa treatment whose goal is General strengthening of the body, lowering cholesterol levels and correction of comorbidities. Only then the attending cardiologist requires such a study, which allows full loading of the myocardium with simultaneous deposition of the ECG. Or treadmill test (treadmill), Bicycle ergometry or under load. If there is no ECG signs of myocardial ischemia and no clinical signs of ischemia (chest pain, shortness of breath), the operation is carried out successfully, and the restore is complete.
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In conclusion, I must say that life after the surgery was long and full, you have to follow medical instructions. We need to eat right to completely abandon bad habits, keep the cholesterol under control and lead an active life, not forgetting every year to visit a cardiologist.