Quadruple Bypass Surgery
The heart is supplied with blood through the coronary arteries. When four of these vessels become narrowed or blocked, whether through atherosclerosis or other reasons, then a quadruple bypass can be performed. This is a surgical procedure where a healthy vein of the patient's is used to reroute the blood around the unhealthy heart artery.
There are two ways the bypass can be done. One is through opening the chest to access the heart. The other is through the use of small incisions to access the heart arteries. The condition of the arteries determines which can be used.
The Surgery
One type of operation requires the patient to be put on a heart-lung bypass machine. The machine circulates the blood while the heart is stopped. The heart is accessed through the breastbone beginning with a 6- to 8-inch incision. The vein grafts are collected from the patient, and the heart machine is connected. The grafts are sutured into place, each attached to the aorta and a point beyond the damaged vessel to be bypassed. The machine is removed and the incision is sutured.
A second type of operation does not use the machine. Instead the area the surgeon is working on is physically kept still while the heart is beating.
A third type of operation is the endoscopic type, where small incisions are made in the chest wall in order to insert robotic surgical tools for the grafting.
History
The first bypass surgery was done in 1960. Seven years later a new technique, developed by Dr. Rene Favaloro, used a graft made from the saphenous vein. This vein was removed from the patient's leg and used to bypass the narrowed heart artery. This became the basis of subsequent surgeries. This procedure was later used by Dr. Dudley Johnson for a bypass on the left coronary arteries. In addition the use of an artery from the chest wall or arm began to be used.
Considerations
Transmyocardial laser revascularization (TMR) is sometimes used in conjunction with bypass surgery. TMR uses a laser to improve the blood flow toward the heart. It isn't a common procedure, and is usually used to reach the heart sections that bypass grafts are less successful. Bypass types of surgery are sometimes referenced by the acronym CABG, pronounced "cabbage."
Warning
Though the long-term outcomes are not that different, bypass surgery is considered to be more risky than angioplasty; but angioplasty is considered less successful than bypass surgery.The risks of bypass surgery could include, stroke, heart attack, infection, narrowing of the graft, problems with cognition, anesthesia complications, bleeding and death. However returning chest pain is the most noted problem.
Significance
Bypass surgery has been found to reduce the heart attack potential, relieve pain and improve mobility. It's the preferred option for certain diabetic cases and for people with more extreme cases of clogged blood vessels.
Tags: bypass surgery, type operation, access heart, chest wall, coronary arteries, from patient, heart artery