Cardiac surgery is related with bypass surgery and minimally invasive procedures like stenting or balloon angioplasty.
Minimally invasive procedures:
- Balloon angioplasty is an invasive procedure, which opens the narrowed blood vessels. Deflated balloon is inserted into the narrowed blood vessel through a catheter and when it is inflated, the blood vessel widens. Then the balloon is removed and the cavity of blood vessel is restored.
- Stenting is the insertion of a stent into the narrowed part of blood vessel. A stent is a small, mesh-like tube that is put on a balloon and inserted in the blood vessel through a catheter. The balloon is inflated in the narrowed part of the blood vessel. When the stent expands till fully restored cavity of blood vessel, the balloon is deflated and removed. The stent stays in the blood vessel and maintains the normal blood flow and size of cavity in the blood vessel. It also helps to avoid future narrowing of blood vessels.
POSTOPERATIVE PERIOD: After surgery, patients can go home the next day and get back to daily routine quite soon. Minimally invasive procedures reduce the possibility for complications. However, a patient should follow doctor’s orders to take anticoagulants (to reduce coagulation of blood) as prescribed, during the postoperative period.
Bypass surgery is a special treatment for diseases, related with arteries. It is done through a long incision in the chest, the surgeon takes a section of healthy blood vessel and attaches below the blocked artery so that blood flow is diverted (bypassed) around the narrowed portion of the diseased artery. Bypass surgery restores the blood flow, however it does not prevent from the recurrent clogging or clogging in other blood vessel.
Bypass surgery can be performed differently:
- With a stopped heart, when blood flow, lungs and heart are supported by a machine. More than 70% of all surgeries are done with a stopped heart. The procedure lasts from three to six hours and heart is stopped for 30-90 minutes during surgery.
- With a beating heart, when a special equipment is used to stabilize the heart during surgery. For this type of surgery there is no need to use supporting machines, heart and lungs can function on their own. That area of the heart, where bypass surgery is performed, is stabilized and the movements are reduced, while other areas are functioning normally. This surgery is successfully done for thousands of patients in the whole world.
Several tests are required before the bypass surgery:
- Chest X-Ray (coronarography, for example) is applied to identify the clogged area. During coronarography, contrast dye is injected into a coronary artery through a catheter. This procedure allows to see arteries and their narrowing with an x-ray machine.
- Blood tests
- Electrocardiogram is applied to find the place where the heart does not function properly and what is causing the disorder.
Bypass surgery with a stopped heart differs from bypass surgery with a beating heart in longer hospitalization (for 7-10 days) period, longer recovery (6-8 weeks) and higher possibility for complications. In a case of a surgery with a beating heart, patients can leave the hospital after 2-3 days, recovery is much faster and they can get back to normal activities after 4 weeks. As a result, patients no longer suffer from previous symptoms and they disappear for a long period of time. However, bypass surgery with a beating heart is suitable not for every patient.
After leaving the hospital, patients have to do a cardiac rehabilitation, which should normalize the heart, its work and heartbeat. This type of rehabilitation improves hemodynamics, physical stamina, changes the factors of risk, teaches to use prevention measures for heart and blood vessels diseases and daily life gets more active.
Patients should visit the cardiologist after four months and after one year.
Cardiac rehabilitation consists of:
- Personal recovery plan;
- Kinesiotherapy (individual kinesiotherapy, kinesiotherapy in groups, velotraining, doses of walking or walking in special routes);
- Light therapy;
- Psychological rehabilitation (individual consultation, relaxation sessions, watching relaxing videos, music therapy, blood pressure regulation groups, stop smoking groups);
- Educational programs for patients (correction of the factors of risk, eating habits; teaching about heart failure, tracking your blood pressure).