When Does a Person Need Bypass Surgery?

 Coronary artery disease (CAD) affects millions of people worldwide and is a leading cause of heart-related complications and death. While lifestyle modifications and medications can help manage CAD, there are cases where bypass surgery becomes necessary. 

A leading heart doctor in Delhi, Dr. Sujay Shad explains that coronary artery bypass grafting (CABG), commonly known as bypass surgery, is a surgical procedure that reroutes blood flow around blocked or narrowed arteries, restoring blood supply to the heart. He further elaborates on the need for getting a well-qualified surgeon to perform this kind of surgery. 

In this blog, we will explore the circumstances in which a person may require bypass surgery.

When Does A Patient Need Bypass Surgery?

• Severe Coronary Artery Disease

The primary indication for bypass surgery is the presence of severe coronary artery disease. When the coronary arteries, which supply oxygen-rich blood to the heart muscle, become narrowed or blocked due to the buildup of plaque, it can lead to chest pain (angina), shortness of breath, and other symptoms. If lifestyle changes, medications, and less invasive procedures, such as angioplasty and stenting, are not effective in alleviating symptoms or improving blood flow, bypass surgery may be recommended.

• Multiple Blocked Arteries

Bypass surgery is particularly beneficial when multiple coronary arteries are blocked or narrowed. If three or more major arteries supplying the heart are severely obstructed, bypass surgery is often the preferred treatment. By creating new pathways for blood flow using grafts, such as veins from the leg or arteries from the chest, the surgeon can bypass the blockages and improve blood supply to the heart muscle.

• Left Main Coronary Artery Disease

The left main coronary artery is a critical artery that forms a large portion of the heart muscle. If it becomes significantly narrowed or blocked, bypass surgery may be necessary. The left main artery disease requires prompt attention, as it poses a higher risk of life-threatening events, such as heart attack or cardiac arrest. Bypass surgery can effectively restore blood flow to this vital artery and reduce the risk of complications.

• Failure of Non-Surgical Treatments

Before considering bypass surgery, heart surgeons usually exhaust non-surgical treatment options, such as medications and lifestyle modifications. If these interventions fail to control symptoms, improve blood flow, or prevent further progression of coronary artery disease, surgery may be the next logical step. Bypass surgery can offer long-term relief and reduce the need for frequent hospital visits or invasive procedures.

• Failed Angioplasty or Stenting

Angioplasty and stenting are minimally invasive procedures commonly used to treat coronary artery disease. During angioplasty, a balloon-tipped catheter is used to widen the narrowed artery, and a stent (a tiny mesh tube) is placed to keep the artery open. However, in some cases, these interventions may not achieve the desired results. If the artery re-narrows or if complications arise following angioplasty or stenting, bypass surgery may be required to restore blood flow effectively.

Heart Surgery Cost?

Those who want to know the heart surgery cost in Delhi must understand that many factors affect its costs such as: 

• The severity of the condition. 
• Location of the facility. 
• Doctor’s qualification. 
• Doctor’s experience. 
• Doctor’s expertise, etc. 

Importance of a Bypass Surgery

Bypass surgery is a vital and highly effective treatment option for individuals with severe coronary artery disease. It becomes necessary when non-surgical treatments and less invasive procedures fail to provide relief or improve blood flow adequately. By creating alternative pathways for blood circulation, bypass surgery restores oxygen-rich blood supply to the heart, reducing symptoms and lowering the risk of life-threatening complications.

If you or a loved one experiences severe chest pain, shortness of breath, or other symptoms associated with coronary artery disease, it is crucial to seek medical attention promptly. A qualified heart doctor can assess your condition, perform diagnostic tests, and determine the most appropriate treatment plan, which may include bypass surgery if necessary.

Remember, each case is unique, and decisions regarding bypass surgery are made on an individual basis after considering various factors. Trust your heart surgeon and his team to guide you through the process and help you make informed decisions to safeguard your heart health. If you are looking for the top heart surgeon in Delhi, visit Dr. Sujay Shad at Sir Ganga Ram Hospital, now!

Things to Know On Open Heart Surgery

 A surgical procedure known as "open-heart surgery" involves cutting open the chest to operate on the heart or nearby arteries. Open-heart surgery is performed by cardiac surgeons to treat severe coronary artery disease (CAD), replace or repair heart valves, or correct structural defects in the heart. Although open heart surgery is complicated, the risk of death is very low. 

In this blog, Dr. Sujay Shad, an experienced heart surgeon who performs open heart surgery in Delhi at Sir Ganga Ram Hospital, shares some valuable information about open heart surgery.

When Would Someone Need Open Heart Surgery?

A CABG could require open-heart surgery. For those with coronary heart disease, a coronary artery bypass graft might be required.

The blood vessels that carry oxygen and nutrients to the heart muscle become hard and restricted with coronary heart disease. "Hardening of the arteries" is the term used to describe this condition.

The walls of the coronary arteries become hardened when fatty material deposits itself as plaque. Because of this plaque, blood cannot flow through the arteries easily. A heart attack could happen if the heart's blood flow is compromised.

Additionally, open-heart surgery is performed on:

• repair or replacement of heart valves, which is necessary to allow blood to flow through the heart.
• repair any heart tissue that is harmed or is abnormal.
• medical implants that promote proper heartbeat
• heart transplant: the replacement of a diseased heart with a donor heart

What Kinds of Open Heart Procedures are there?

Open-heart surgery is a term used to describe surgeries in which the heart is accessed through a chest incision in order to perform interventions on the heart or its major blood vessels. Here are some examples of the various open-heart procedures:

• CABG: Coronary Artery Bypass Grafting

The most frequent kind of open-heart surgery is this one. It involves using grafts (blood vessels taken from another part of the body or synthetic grafts) to create a bypass for blood flow around blocked or narrowed coronary arteries.

• Valve Replacement or Repair

This procedure is carried out to fix or swap out unhealthy or damaged heart valves. The affected valve is removed during the procedure, and either a mechanical valve or a biological valve is used in its place. 

• Heart Transplant

The need for a heart transplant may arise in cases of severe heart failure. The diseased heart is removed during this procedure, and a donor's healthy heart is put in its place.

• Arrhythmia Treatment

Heart irregularities, or arrhythmia, cause irregular heartbeats. During surgery, a pacemaker or an ICD is implanted inside the body to treat irregular heartbeats. Treatments for arrhythmia ablation are now readily available thanks to cutting-edge technology and skilled surgeons.

 

Procedure of Open-Heart Surgery

1. Patients will initially receive anesthesia to put them to sleep.
2. After that, the surgeon will carefully make an 8 to 10 inch incision in the chest.
3. The patient is connected to a heart-lung bypass machine as soon as the heart is visible to help with blood flow throughout the procedure.
4. A healthy vein, usually the saphenous vein from the leg, will be used to patch up the fractured vein.
5. The surgeon will close the incisions after the procedure.

How Long Exactly Does Recovery from Open Heart Surgery take?

Each person's situation is unique. However, the average length of stay in the intensive care unit is one or two days. One might not be able to eat or drink anything during this time. To help one breathe, they might also need to wear a face mask or nasal prongs. Depending on the patient's health and the procedure they underwent, they will recover differently at home. In order to track one’s recovery, they will also require ongoing care in the form of heart examinations and tests.

When recovering:

• Being exhausted and experiencing some pain are perfectly normal feelings.
• Follow the surgeon’s recommendations for wound care, and keep an eye out for indications of infection, such as redness or discharge, near the chest wound.
• Any potentially serious infection-related symptoms should be treated right away. Breathing issues, fever, and excessive perspiration are symptoms.

For more details on open heart surgery or mitral valve repair  in India, make an appointment with Dr. Sujay Shad today at the prestigious Sir Ganga Ram Hospital. 

Heart Bypass Surgery: Symptoms, Diagnosis, Procedure, And More

Heart bypass surgery is used to treat a blocked artery bypassing a blocked artery to improve blood flow to the heart. The surgeon uses a healthy blood channel from another part of the body to connect to the beginning and end of the obstruction, allowing blood to flow in a different direction. This new channel allows blood to pass through the restricted area, allowing more blood to reach the heart.

Coronary artery disease is treated with heart bypass surgery. Plaque, a waxy substance inside the heart's arteries, blocks blood and oxygen from reaching it. Depending upon the complexity of the surgery the bypass surgery cost in Delhi is determined by the heart bypass surgeon at Sir Ganga Ram Hospital, Dr. Sujay Shad.

Depending on how many arteries are blocked, there are four main types of heart bypass surgery:

• Single-bypass surgery
• Double bypass surgery
• Triple bypass surgery
• Quadruple bypass surgery.

 Symptoms of blocked arteries

• Coronary artery disease occurs when the coronary arteries become obstructed.
• Numerous factors contribute to this, including genetics, lifestyle, diabetes, smoking, high blood pressure, and high cholesterol. As the arteries narrow and the heart loses oxygen, symptoms such as chest tightness, shortness of breath, or even a heart attack occur, in which a piece of the heart muscle dies from a lack of oxygen.
• Angina is commonly described as chest discomfort but not constantly uncomfortable. Most patients describe it as an uncomfortable feeling or tightness in the chest, with discomfort in the left arm, shoulder, jaw, or abdomen.
• Some people with coronary artery disease do not experience any discomfort or tightness and may even have a so-called silent heart attack. Women and diabetics are more prone to this.

Why is Coronary Artery Bypass Surgery done?

Coronary artery bypass surgery is performed for two reasons: to ease coronary artery disease (CAD) symptoms such as angina and to improve survival when there are significant or many blockages in the heart arteries. When medical treatments such as blood thinners and drugs that relax the arteries, lower the heart rate and lessen chest pain have not been able to improve symptoms of CAD, it is performed either as an emergency procedure after a heart attack or as an elective procedure.

Ideal candidates for heart bypass surgery

The build-up of a fatty material known as "plaque" can constrict or clog the coronary arteries. It is known as atherosclerosis. If a patient has many sites of atherosclerosis, the doctor may advise heart bypass surgery. If a patient has:

• Pain in the chest that does not improve with medication
• Unstable angina
• Had a previous heart attack
• Coronary artery disease: not appropriate for coronary angioplasty or stenting.

Diagnosis

The common route to surgery would generally begin when a patient seems to have chest tightness after walking up a hill that resolves when they stop walking. The doctor may arrange for a stress test in which the patient exercises on a treadmill.

At the same time, the heart is monitored using ultrasonography (echocardiography) or an ECG to look for signs of oxygen depletion (ischemia). If the stress test is positive and there are signs of oxygen starvation, the patient will be referred to a cardiologist, who will perform coronary angiography.

The angiography will assess the degree of coronary disease and whether the patient requires surgery or alternative medicinal therapy.

Before the procedure

Blood tests, an electrocardiogram (EKG), and chest X-rays will be conducted before surgery. Coronary angiography is an X-ray procedure that a physician may use. A special dye is used to show how blood flows through arteries.

Patients will also be informed if any dietary or lifestyle changes, as well as prescription changes, are required before surgery. Inform the doctor about any vitamins or supplements the patient is taking, even if they are natural, in case they increase the risk of bleeding. Patients must also plan for their post-surgery recovery.

During the procedure

Coronary artery bypass surgery is done either open or through an incision in the sternum.

During the procedure, a healthy blood vessel is removed from a body part such as the leg (long saphenous vein), arm (radial artery), or chest (internal thoracic artery). The heart is carefully stopped while the grafts are being generated. During this time, a heart-lung machine mimics the heart and lungs by delivering oxygen, removing carbon dioxide, and keeping the blood flowing.

If the artery graft is obtained from the leg or arm, one end is joined to the aorta, and the other end is attached to the coronary artery beyond the obstruction by fine sutures. Blood can now readily reach the heart after bypassing the blocked and constricted region.

If the internal thoracic artery is being used, the surgeon will redirect it by removing one end of it and reattaching it below the blocked section of the coronary artery.

After the surgery, the heart will be restarted, the heart-lung machine removed, and the incision repaired with absorbable sutures. The sternum bone is reconstructed with stainless steel wires that remain in place when the bone heals. They are inert, do not set off metal detectors, and are MRI-compatible after 6–8 weeks.

If one wants to know about this surgery in detail they can consult with Dr. Sujay Shad, Heart Surgery Doctor in India at Sir Ganga Ram Hospital.

After the procedure

• When a person wakes up, a tube will be put into their throat to assist them with breathing, and it will be uncomfortable and disturbing, but it is necessary, and within 24 hours, a doctor will usually remove the tube.
• On average, a person will spend around a week in the hospital after surgery, and soreness and night sweats are normal, and patients can expect to cough a lot because there may be some fluid in the lungs.
• Most patients start eating and moving around after removing the breathing tube.
• Platelet inhibitors are routinely used as post-surgery therapy to help prevent blood clots.

Post-operative guidelines

Patients must follow a few post-operative guidelines after surgery, which include:

• Lifting heavy objects, performing rigorous exercises, and driving should be avoided for several weeks after surgery to allow the sternum to recover.
• To alleviate chest pain and avoid blood clots, medications may be recommended.
• While recuperating, the doctor may advise patients to wear compression stockings around the calf muscles.
• Patients should consult the doctor when they notice redness, swelling, irregular heartbeats, palpitations, chest pain, difficulty breathing, or weakness.

Patients can treat or prevent the advancement of CAD with lifestyle changes, such as:

• Exercise regularly.
• Consume a low-salt, low-cholesterol diet.
• Avoid smoking and drinking alcohol.
• Lose weight if a patient is overweight.
• Control diabetes and high blood pressure.

For more information on heart bypass surgery in Delhi, and how this is performed. Consult Dr. Sujay Shad at Sir Ganga Ram Hospital in New Delhi. All types of heart surgeries are performed at the hospital in patients of all ages.