What is Coronary Bypass Surgery?

Coronary bypass surgeryIt is a cardiovascular surgery that has an important place in preventing heart attack in cases of stenosis or blockage in the coronary vessels feeding the heart. Stenosis or occlusion in the coronary arteries is the most important factor in the occurrence of a heart attack. In these cases, blood flow to the heart stops, the heart muscle cannot receive the necessary oxygen and nutrition. Therefore, it cannot continue its normal operation. In preventing this condition that makes the heart unable to work or in removing the resulting blockage; The process of placing veins taken from other parts of the body by bridging them in the coronary vessels and ensuring blood flow is called coronary bypass surgery. Thanks to coronary bypass surgery, the heart muscle receives the necessary nutrition and can continue to function normally.

Surgery Duration
3-6 hours
Recovery Time
6-12 Months
Discharge Time
3-7 Days

Coronary Bypass Surgery

Coronary bypass surgery is the placement of a new vessel to carry blood distal (forward) to the blockage as a result of the cholesterol limes formed in the vessels that flow outside the heart and provide blood to the muscle, blocking the flow. Heart surgery performed for this purpose is very successful today. Surgery is generally recommended for coronary arteries with blockage in more than a single vessel. Factors such as the number of vessels, widespread occlusion, previous heart attack and decreased heart power play a role in the success of the surgery.

After the chest opening, which is usually done with minimally invasive techniques from the front of the chest, the pericardium, which is the outer membrane of the heart, is opened and cannulas are placed in the heart chambers, the heart is connected to the lung pump, and the heart is stopped and the surgery is performed. This procedure can be performed without stopping the heart, depending on the location and diameter of the vessel. (Bypass in a working heart) It is generally preferred in cases such as kidney failure, chronic lung disease, previous cerebrovascular disease (stroke).

Many minimally invasive techniques have been developed for coronary bypass surgery. However, most of them can be done in a working heart.


How to ByPass?

The vein to be used for bypass is usually the leg vein, however, the mammarian vein, which is the artery that runs through the chest and supplies blood, is used. Although the radial artery taken from the arm was used in the past, it is not preferred today because it causes premature blockage and complaints such as pain, coldness and bruising in the arm. Since the vein removed from the leg is immediately subcutaneous, it does not cause any complications in the leg. However, it should not be forced or damaged during removal. For this purpose, it should be taken into consideration that techniques performed for aesthetic purposes may cause vascular damage and early occlusion in the future. Moreover, since the skin incision is closed aesthetically, it will not be very noticeable in the future. The quality of the bypass means long-term operation.

The intrathoracic artery is generally used to bleed the coronary artery on the front of the heart. Although patency rates are known to be high, leg veins performed with good techniques do not remain blocked for a long time.

Importance of Coronary ByPass Surgery

Keeping the duration of the heart-lung machine in surgery short and the anastomosis technique being of high quality will ease the post-operative intensive care period. Early awakening and activation in intensive care accelerates recovery. No matter which minimally invasive technique is used, chest closure is of particular importance. The infection rate is low in a well-covered chest, and there is no risk of opening and non-union. This accelerates the patient's early discharge and early return to daily life.

Patients who are planned to have coronary bypass surgery should not forget that; The procedure performed is not intended to cripple, quite the opposite; is to heal the injury. Therefore, patients should not be afraid after surgery and should return to their active life more easily than before. Advantages of Coronary Bypass Surgery for a Working Heart


What is Coronary Vascular Diseases?

Diseases that occur due to stenosis, occlusion and deterioration of the vascular structure in the coronary vessels are called coronary vascular diseases.


Before and After Coronary ByPass Surgery

Prof. Dr. Yavuz Beşoğul

The vessels that feed the heart are called coronary arteries or coronary veins. There are 3 coronary arteries that feed the heart. Coronary artery diseases may occur due to blockages or narrowings in these coronary vessels. In these cases, the heart cannot receive enough nutrition and sudden complete blockage may cause heart attacks. Coronary bypass surgery is performed in cases of stenosis and blockage in these vessels, by bridging the vessels taken from other parts of the body to the vessels in the heart and ensuring blood flow.


Coronary Vascular Diseases Treatment

In the treatment of coronary vascular diseases; The most appropriate treatment method is decided after the necessary tests, analyzes and evaluations are carried out by the specialist physician, depending on the patient's condition and the degree of stenosis or occlusion in the coronary vessels. According to these evaluations, drug therapy, balloon-stent applications or coronary bypass surgery are among the treatment options. In addition, the presence of other diseases, the condition of the person's vascular structure and problems should be determined and the most appropriate treatment option should be determined for the individual. Coronary artery patients, in line with the recommendations of specialist physicians; It is beneficial to take precautions by paying attention to a healthy and balanced diet, not smoking, and living an active lifestyle that includes exercise and sports.


Things to Consider After Coronary Bypass Surgery

One of the most important issues after coronary bypass surgery is that patients act as recommended by the physician. One of the most important issues that should be taken into consideration is that patients use their medications as prescribed. In addition, smoking, which plays an important role in the emergence of cardiovascular diseases, should not be consumed, and attention should be paid to diet regarding cholesterol. Animal fats should be avoided. Patients who quit smoking due to heart surgery should not start smoking again. However, regular exercises should be included in daily life in line with the recommendations of specialist physicians. In addition, regular physician check-ups to check and monitor the patient's condition and heart health should not be neglected. It should not be forgotten that a healthy heart means a healthy life. When evaluated in general; It is beneficial for patients to have a lifestyle in which they take preventive and protective measures for cardiovascular health.

Causes of Coronary Vascular Diseases

In coronary artery diseases, there is stenosis or blockage in the vessels feeding the heart. Narrowing, atherosclerosis, accumulation of intravascular fatty plaques and clot formation as a result of deterioration of the coronary artery structure can cause these blockages. In cases of obstruction, blood flow cannot continue normally. Genetic factors are the main causes of coronary artery diseases. Especially people with a family history of coronary artery disease or heart attack should have the necessary check-ups before the symptoms of the disease appear. In addition, some diseases and habits in a person's life are among the risk factors. Causes of coronary artery diseases are:

  • genetic factors
  • vascular diseases
  • Deterioration of vascular structure due to aging
  • Cigarette
  • Hypertension
  • Cholesterol
  • still life
  • Stress

How is Coronary Bypass Surgery Performed?

Coronary bypass surgery can be performed in two ways: bypass surgery by stopping the heart and connecting it to a heart-lung machine, or bypass surgery on a working heart. Coronary bypass surgeries can be performed with open surgery, or with minimally invasive surgery if the necessary eligibility conditions are present, that is, with small incisions from the armpit, under the breast, and from the outer breast fold, without splitting the chest in the middle and without cutting the breastbone. Coronary bypass surgery can be performed in cases where there is no response to drug treatment or when intervention is required due to obstruction. It can be applied when necessary. In some cases, coronary bypass surgery may be preferred because balloon or stent application is not sufficient.

In coronary bypass surgery, a vein taken from the patient's chest, arm or leg area is stitched to the blocked coronary artery by bridging it. In coronary bypass surgery, the entry location may vary depending on the number of vessels. If a single vessel bypass is to be performed, bypass surgery is performed through small 7-8 centimeter incisions under the breast. Sometimes, when there are two veins, two vein bypass surgery can be performed on the left side, also under the armpit. In heart surgeries performed under the armpit, no bones or muscles are cut. The heart is reached between the ribs and the surgery is completed by performing the necessary intervention. If the bypass surgery performed on a functioning heart involves multiple vessels, it may be necessary to partially open the frontal bone of the chest when there are three vessels or more. Since the bone is not opened completely, but only partially, the patient's risk of infection is lower and the breastbone heals more quickly.

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