What is coronary bypass surgery?

When narrowing of the coronary arteries, which cause chest pain and heart attack, rises above a certain level, it creates an obstacle in the flow of blood. This means that the heart cannot be adequately fed, and therefore cannot fully perform its task. - The surgical procedure applied to eliminate this negative picture is called coronary bypass surgery. The purpose of coronary bypass surgery; to eliminate chest pain if any, and to prevent a heart attack that may occur. Like every organ, our hearts need blood to live and to do their job. Blood comes to our heart muscle through the arteries called coronary arteries. As is known, arteriosclerosis (atherosclerosis) is a disease that can settle on the inner wall of the vessel and cause stenosis in the area where it is located. Coronary arteries are also significantly affected by atherosclerosis. As a result, narrowing and blockages can occur in the coronary arteries, which is the only source for the nutrition of the heart muscle. This picture, which we call ischemic heart disease, usually manifests itself with a pain called “angina”. Although angina is not present in every patient, it is usually the most important precursor of a heart attack. Sometimes, patients can have a heart attack without identifying any pain. When the narrowing in the coronary arteries causing chest pain and heart attack rises above a certain level, they prevent the flow of blood. This means that the heart cannot be adequately fed, and therefore cannot fully perform its task. The surgical procedure applied to eliminate this negative picture is called coronary bypass surgery. The purpose of coronary bypass surgery; to eliminate chest pain if any, and to prevent a heart attack that may occur. Thus, it is aimed to improve the patient's quality of life and prolong the life. WHO IS A CANDIDATE FOR CORONARY BYPASS SURGERY? There are 3 options for treatment in narrowing of the coronary arteries. These; drug therapy is coronary balloon angioplasty (stent applications are considered within this group) and coronary bypass surgery. According to the condition of the disease, the heart surgeon and cardiologist decide together which treatment method to choose. In the selection of treatment method; Many factors, such as the general condition of the patient, the structure of the coronary arteries and the contractile strength of the heart, are effective. HOW LONG DOES THE SURGERY TAKE? The duration of the operation varies depending on the number of bypasses to be performed and additional procedures, if any, and takes about 4 hours. WHAT IS THE CLASSIC METHOD IN CORONARY BYPASS OPERATIONS? It is the most widely used method for coronary bypass surgeries today. Before the operation, the patient is completely anesthetized with general anesthesia. During the operation phase, he does not feel anything and does not feel any pain. The surgeon performing the surgery cuts the breastbone with a special device from top to bottom in order to access the heart. Then the heart and lung blood circulation is connected to the heart-lung machine with special lines. In this method, which is also called open heart surgery, the heart can be stopped for a while, at this stage, the device performs the task of the heart and lungs. The surgeon makes the heart work again after performing the desired operation in the heart, which becomes bloodless and immobile. In the next stage, the connections established with the heart-lung machine are eliminated, and the cut bone is sutured with special steel wires and restored. WHAT IS “MINIMAL INVASIVE” CORONARY BYPASS SURGERY? Minimal investive methods, which mean less trauma to patients and recovery in less time, can only be applied under certain conditions. The structure of the patient, the presence of additional diseases, above all, the location and number of occluded vessels play an effective role in the selection of this method. It is a method generally applied in strictures in the anterior descending branch of the heart (known as LAD for short). In the procedure known as “small incision”, one of these methods, surgery is performed with a 5-6 cm incision under the left breast. The surgery is performed on the working heart and all procedures are done through this small opening. Although it is an attractive method due to early recovery and short-term hospitalization, it has disadvantages such that the breast artery used for coronary bypass cannot be prepared in sufficient quality due to the limited field of vision. WHAT IS A CORONARY BYPASS SURGERY WITHOUT HEART-LUNG MACHINE (WITHOUT PUMP)? In these surgeries, which are also known as the pumpless method, the surgeon performs the operation in the working heart. Therefore, these surgeries are not open heart surgeries. Therefore, many negativities of the heart-lung machine used in the classical method are eliminated. Since there is no device that takes the role of the heart in the pumpless method, the heart continues to pump the blood needed by the body and especially the brain during the process. Therefore, it is necessary to avoid movements that significantly affect the pumping power of the heart. As can be understood from this sentence, it is not always possible to reach the vessels that feed the back wall of the heart in this method. Access to the heart in pumpless surgeries is the same as in the classical method.