What is Multiple Bypass Surgery? Indications, Procedure, Risks

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What is Multiple Bypass Surgery? 

Multiple bypass surgery is a surgical procedure performed to improve the blood flow to the heart. It is used to treat coronary artery disease (CAD), where one or more of the coronary arteries become narrowed or blocked. In multiple bypass surgery, more than one artery is bypassed, which is necessary when several arteries are affected.

The procedure involves taking a blood vessel from another part of the body (usually the chest, arm, or leg) and using it to create a new pathway for blood to flow to the heart muscle. This new pathway bypasses the blocked or narrowed sections of the coronary arteries, thus restoring adequate blood flow to the heart.

In this article, we will be discussing in detail multiple bypass surgery.

• What are the indications for multiple bypass surgery?
• What is the diagnostic procedure before the surgery?
• What is the procedure for this heart bypass surgery?
• How to care after this heart surgery?
• What are the risks of heart bypass surgery?

What are the indications for this heart bypass surgery?

Multiple bypass surgery is indicated in patients with severe coronary artery disease, particularly when multiple arteries are involved. Some conditions in which this bypass surgery is recommended are:

• Severe chest pain (angina): When medication and lifestyle changes fail to control severe angina, and the chest pain significantly limits normal daily activities.
• Severe blockages in the coronary arteries: If the left main coronary artery is severely narrowed or if there are multiple severe blockages in other major arteries, a multiple bypass surgery is recommended.
• Failed angioplasty or stent placement: If previous attempts to open the narrowed arteries using a procedure known as angioplasty or stent placement have failed, the doctor could recommend undergoing a multiple bypass surgery.
• Heart attack: A multiple bypass surgery may be recommended during or after a heart attack if there is evidence of severe artery blockage. ( Know more about- What is Heart Attack ? )
• High risk of heart attack: Identified through non-invasive tests or significant coronary artery disease diagnosed during an angiogram.

What is the diagnostic procedure before bypass surgery?

The following diagnostic tests are recommended before a heart bypass surgery:

• Physical examination and medical history: The doctor will assess the patient physically. The symptoms and risk factors for heart disease are also assessed. 
• Blood tests: This test helps in checking the general health of the patient and if the patient is fit to undergo surgery. Some underlying medical conditions can also be detected using this test.
• Chest X-ray: It helps the doctor check the condition of the patient’s heart and lungs.
• Electrocardiogram (ECG): This test helps in the detection of abnormalities in the heart’s rhythm and electrical activity.
• Stress tests: This test helps in checking the heart’s function during physical exertion.
• Echocardiogram: An ultrasound of the heart is taken to view its structure and function in detail.
• Coronary angiography: This test involves injecting a dye into the coronary arteries. X-ray images are then taken to identify the location and severity of blockages. ( Know more about- cost of coronary angiography in Bangalore ? )

How to prepare for bypass surgery?

The preparation for heart bypass surgery includes the following steps:

• The doctor may recommend adjusting or stopping certain medications like anticoagulants and antiplatelet medicines before surgery.
• The patient needs to inform the doctor if he or she has any known allergic reactions.
• If the patient is currently taking any medications or has known medical conditions, the doctor should be informed about the same.
• The patient needs to follow a healthy lifestyle that includes eating a healthy diet, exercising regularly, maintaining a healthy weight, and quitting smoking before the surgery.
• The patient will be informed about the potential risks and benefits of the procedure, as well as the expected quality of life after the surgery.
• The patient will need help with daily tasks after the surgery and needs to make arrangements at home for the same.
• The patient will be asked not to eat or drink anything for at least eight to twelve hours before the surgery. ( Know more about- Home Remedies for Chest Pain )

What is the procedure for bypass surgery?

The doctor performs a heart bypass surgery in the following way:

• The procedure is generally done under the effect of general anesthesia, which means that the patient is made unconscious before starting the procedure.
• The surgeon then makes an incision down the middle of the chest to access the heart, known as median sternotomy. This method is known as open surgery.
• In select cases, the surgeon uses a minimally-invasive technique that involves making only a small three to five-inch cut between the ribs and then uses special instruments and a thoracoscope to view inside and operate on the heart.
• The heart is then stopped, and the patient is put on a heart-lung bypass machine to circulate the blood and oxygen throughout the body. In some cases, while using the minimally-invasive technique, the surgery may be performed without putting the patient on a bypass machine (off-pump heart bypass surgery).
• The blood vessels or grafts are then harvested from the arm (radial artery), leg (saphenous vein), or chest (internal mammary artery).
• The surgeon will then attach one end of the graft above the blockage and the other end below the blockage, therefore, creating a new route for blood flow.
• The heart is then restarted, and the patient will gradually taken off the heart-lung bypass machine.
• The incision is then closed using sutures and the patient is moved to the intensive care unit (ICU) for monitoring. ( Know more about- What is Echocardiography? )

How to care after this heart bypass surgery?

The following are the different ways of post-operative care following this heart bypass surgery:

• The patient is then monitored in the ICU for vital signs, heart function, and wound healing immediately after surgery.
• The doctor will administer pain-relieving medications to manage the post-operative pain.
• The patient is encouraged to gradually resume movement and activities, including walking and breathing exercises.
• The patient will generally stay in the hospital for one to two weeks after the surgery before being discharged.
• The patient will be given instructions on how to care for surgical wounds to prevent infection.
• The doctor will give instructions on the continuation and adjustment of medications such as blood thinners, beta-blockers, and cholesterol-lowering drugs after the surgery.
• The patient will need to undergo cardiac rehabilitation after the surgery, which is a structured program of exercise and education to improve cardiovascular health.
• Regular monitoring and tests are recommended to assess the success of surgery and check heart health after surgery.

What are the risks of heart surgery?

Multiple bypass surgery could be associated with the following complications:

• Infection 
• Bleeding 
• Heart attack
• Stroke
• Kidney failure ( Know more about- What is Acute Kidney Failure ? )
• Abnormal heart rhythms (arrhythmias)
• Short-term memory problems or problems in concentration 

We hope that we were able to answer all your questions about multiple bypass surgery through this article.

If you want more information about heart bypass surgery, you can contact a good cardiac surgeon.

We only aim to give you information through the article and do not recommend any medication or treatment in any way. Only a qualified doctor can give you good advice because no one else is better than them.