The term “bypass” can be explained as creating a bridge. Bypass surgery is a procedure performed to restore blood flow to blocked heart arteries using the patient’s own veins or artificial grafts. It is conducted to restore blood flow and revitalize the area that was being supplied by the blocked artery.

How is Coronary Bypass Surgery Performed?

Coronary bypass surgery can be performed in two ways:

1. On a Stopped Heart
2. On a Beating Heart

The surgery is performed under general anesthesia. The heart is accessed by cutting the breastbone (sternum). In the first type, “on a stopped heart,” the heart is stopped, and the heart-lung machine maintains blood circulation in the body. The heart-lung machine takes over the functions of the heart and lungs while the bypass procedure is carried out. Commonly, the left internal mammary artery, radial artery from the arm, and veins from the inside of the leg are used. Once the procedure is complete, the heart-lung machine is disconnected, the heart and lungs resume function, and the bone and other tissues are repaired to conclude the surgery.

In the “on a beating heart” coronary bypass surgery, the bypass procedures are performed while the heart continues to beat, and the heart-lung machine is not used.

The decision to perform the surgery on a stopped or beating heart is made by the surgeon, based on the patient’s coronary angiography results, additional health conditions, and any previous surgeries.

What Happens After Coronary Bypass Surgery? What Should be Monitored?

After the surgery, the patient is taken to the intensive care unit and connected to a ventilator, where vital signs are closely monitored. If the patient’s condition is stable, they are gradually awakened and disconnected from the ventilator. The patient will need to start breathing exercises with the help of a respiratory physiotherapist, as an increase in mucus in the bronchial tubes is normal after general anesthesia. Depending on the patient’s condition, they can be discharged from the hospital within 6-7 days.

One week after discharge, the patient must return to the hospital for a check-up to assess the healing of the wounds, perform blood tests, and take a chest X-ray.

First Two Months After Surgery:

During the first two months, it is crucial for the patient to be mindful of their movements to avoid disrupting the healing of the breastbone. Key recommendations include:

• Bend at the knees when lowering the body, rather than using the upper body.
• Avoid reaching for objects above shoulder height.
• When standing up, use the legs for support rather than the arms.
• Regularly check the surgical wounds, especially after showering, ensuring they are dry and antiseptics are applied as needed.
• Wear a chest brace for two months to support the breastbone.
• Take prescribed medications consistently.
• The patient should lie on their back for at least the first six weeks, as sleeping on the sides may interfere with the healing of the breastbone.

To prevent blood clots (embolisms), it is important to wear compression stockings. When coughing or sneezing, the front of the brace should be held together with the hands to provide additional support. It’s also essential to perform the exercises recommended by the physiotherapist at home.

Other Post-Surgery Recommendations:

• Keep track of weight, and if there are any significant changes, consult the doctor.
• Follow a low-fat, low-salt diet.
• Eat small, frequent meals, especially in the first month.
• During the first week after discharge, rest at home. After that, the patient can start walking on flat surfaces for 15 minutes a day to improve digestion, lung function, and reduce the risk of blood clots.

Following these recommendations will aid in a smoother recovery and reduce complications post-bypass surgery.