By Vassilios N. Kotsis MD, Cardiac Surgeon, Director of Cardiac Surgery and Beating Heart Surgery Center, Athens Medical Center
If you need to have a coronary bypass, it's only natural to feel stressed. Talking to your cardiac surgeon about why and how the surgery is performed can help you calm down and deal with it courageously and with positive thinking.
First of all, the bypass will help you relieve your symptoms, which usually include chest pain or shortness of breath. It will also help you get back to your everyday habits without fear of a new heart attack or other heart problems.
You know it's necessary to go through it, but you feel it's a severe operation.
Here are answers to 6 questions you may have to help you move forward with your operation confidently:
- Is surgery the best choice for my heart problem?
Both conservative drug therapy and angioplasty can help in coronary artery disease. However, it is still the treatment of choice in coronary heart disease and has better long-term results.
- Should the bypass be performed with extracorporeal circulation or with a beating heart?
Studies have shown that the greater the risk of an operation, the better results we have if it is carried out with a beating heart. In classical cardiac surgery, the function of the heart and lungs is substituted by the machine for the extracorporeal circulation. In the beating heart or off pump coronary surgery we use special stabilizers that immobilize parts of the heart and the surgery resembles any other operation, with the heart functioning. Older patients, patients with liver problems, vascular patients, diabetics and those with high risk of stroke are patients who have absolute evidence of beating heart surgery.
- Can all incidents be treated with a beating heart surgery?
At Athens Medical Center there is a specialized center of beating heart surgery in which all operations are carried out off pump. There is already 20 years of experience. It has been shown that the effectiveness of this technique, both in the short and long term, is directly correlated to the surgeon's experience.
- How painful is the bypass surgery?
Median sternotomy is the less painful incision. After removing the intubation in the ICU and throughout the hospital stay, there is a slight feeling of pressure in the chest that is treated with simple non-prescription analgesics, like paracetamol.
- How long does recovery take?
Recovery depends on a number of factors, including age and physical status. In cases of beating heart surgery, the mobilization is immediate from the first postoperative day. Animated, with full nutrition and minimal pain, on the fourth postoperative day the patient can return home.
- What can and what can I not do after surgery?
The important thing is to mobilize off the bed as soon as possible and to protect the stability of the sternum. This is done by avoiding weight lifting and minimizing the movement of the hands. Upon return home all activities are feasible, but in a measured way for the first 6 weeks. After 8 weeks the body will have fully recovered. The return at work the return is possible in 3 to 4 weeks.
