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Bypass surgery or coronary artery bypass graft (CABG) surgery is a procedure used to treat angina or chest pain and to decrease the risk of a heart attack and death caused by coronary artery disease (CAD). In this type of disease, the coronary arteries which supply the myocardium or heart muscle with blood become blocked, stiff, or narrowed due to cholesterol plaques or blood clots. Bypass surgery is usually recommended for individuals with blockages in two or three main coronary arteries as well as individuals that are not suitable for or have not responded well to other treatments.
A bypass may involve two or more coronary arteries. In a quadruple bypass, four coronary vessels are bypassed using grafts made from veins or arteries taken from the limbs and other parts of the body. This medical procedure is a major surgery that is often necessary for patients with severe heart disease. Other less invasive procedures to open blockages in the coronary artery include angioplasty, medicated stents and drug therapy. Quadruple bypass surgery prognosis is generally positive as it opens up previoulsy blocked arteries that could have a fatal heart attack, but depends on several factors.
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Life Expectancy after Heart Bypass Surgery
In most patients bypass grafts last for ten to fifteen years. The average survival expectancy five years after a bypass surgery is 90 percent. After fifteen years, the survival rate drops to 55 percent, and after twenty years to 40 percent. Some patients may require additional surgery for new blockages ten years or more after a bypass procedure.
According to medical studies, patients who undergo bypass surgery have improved rates of survival than those treated with drug therapy alone. However, statistics show that five years after surgery, the difference between the two procedures may be minimal. The age and health of the patient affects the outcome of the surgery; younger patients with no other disease complications are more likely to have high survival rates while older patients usually suffer additional coronary artery disease. Individuals with health problems such as diabetes, peripheral vascular disease, high blood pressure, high cholesterol, emphysema, and kidney disease have higher risks of complications including further coronary blockages.
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Survival Rates and Quality of Life Depend on Age and Disease Complications
After a bypass surgery, patients generally experience significant improvement or complete relief from the symptoms of coronary artery disease. This improves their quality of life as physical activity will not cause angina, shortness of breath, and other symptoms. Approximately 70 percent of patients experience complete relief from angina symptoms and 20 percent have partial relief after surgery. Most patients remain symptom free for several years, but many will have reoccurring blocked arteries and symptoms that will require medical treatment again.
Immediately after surgery, patients have an extensive healing period in which activities and movements that may open the incision are limited. The surgical wound healing requires infection care and pain medication. Physiotherapy and light exercise is needed to improve blood flow and general health as well as muscle healing. Drug and diet therapy are also very important and must be maintained. Complications such as heart arrhythmia, stroke, infections, and kidney failure may occur after heart surgery and patients should be aware of risks and informed of how to maintain the best recovery possible.
Bypass surgery is not a cure for coronary artery disease; it is an effective, long-term treatment that allows the heart to work in a healthy manner again. However, patients must continue to ensure that the new grafts do not become blocked again. Quadruple bypass surgery prognosis and survival rates depend on the right nutrition, exercise,age, other diseases and medications.
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Clark & Kumar: Clinical Medicine Fifth Edition. WB Saunders, London 2002