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About Heart Bypass Surgery
Coronary artery bypass grafting (CABG), or colloquially, heart bypass, is a surgery performed for patients experiencing complications due to coronary artery disease (CAD). Every surgery has its risks, but, especially with the chest, patients may experience post surgery problems after heart bypass surgery. These complications can be for several different reasons. It is also important to realize that bypass surgery has a long recovery period, so complications are adverse reactions different from normal recovery.
It is important to know a little about a specific type of bypass surgery before worrying about complications following it. Traditional CABG surgery involves a six to eight-inch incision through the sternum, or breastbone, so that the surgeon has a clear path to the heart. The surgery is performed "on-pump", meaning that the heart is stopped, and circulation is facilitated by a heart-lung machine.
Another form of this surgery can be performed "off-pump"; the surgeon operates on the arteries of the heart while only a portion of the heart is stabilized. Patients with an increased risk of complications from using a heart-lung machine receive this type of surgery. These include those patients with "vascular disease, heavy plaque buildup in the aorta (aortic calcification), carotid artery stenosis (narrowing or blockage in the arteries leading to the brain), prior stroke or transient ischemic attacks (TIAs), or breathing or kidney function problems," according to WebMD's website.
Recently, more and more bypass operations are being performed using minimally invasive techniques. These surgeries are performed through small incisions; generally, the largest is about three inches, but some incisions can be less than an inch in length. These surgeries have shown a wealth of benefits including shorter hospital stays and recovery periods, fewer post surgery complications and less pain for most patients.
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Perhaps the most common post surgery problem after heart bypass is bleeding. This can result from nearly anything. Bleeding can occur at the bypass site because it takes time for scar tissue to form and completely close the replacement artery.
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Another common problem following CABG surgery is arrhythmia, or abnormal cardiac rhythm. These occur when parts of the heart beat out of sync with the rest of it. Arrhythmia presents in about a quarter of patients as atrial fibrillation, according to an empirical study, which is when the upper chambers of the heart quiver rather than contract fully. These are usually diagnosed using an EKG to determine abnormal electrical functioning of the heart muscle.
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As stated before, minimally invasive techniques have lower levels and frequencies of complications. In as many as half of CABG patients, clinically detectable neurological problems occur following "open-chest" bypass surgery. Many of these neurological issues are things like memory loss or trouble concentrating, and usually, these symptoms disappear over time. More serious neurological complications can include changes in vision.
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As with any surgery of this magnitude, the possibility of infection is great. Patients are usually given a round of antibiotics to help keep this from happening. However, it is possible, particularly in patients with diminished health statuses prior to surgery. Infection of the bypass site is less common than infection of the incision site.
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There exist other complications that are much less common in CABG patients. Also know that complications can be exacerbated by certain risk factors, only some of which are controllable. Some of these less common post surgery problems include heart attack, stroke, lung problems (like pneumonia), kidney dysfunction and abnormal scar formation.
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WebMD: Heart Bypass Surgery: Procedure Types, What to Expect
Kaiser Permananente: Coronary Artery Bypass Surgery for Heart Attack and Unstable Angina
Texas Heart Institute: Coronary Artery Bypass Surgery
The Society of Thoracic Surgeons: What is Coronary Artery Bypass Grafting (CABG)?
Mayo Clinic: Coronary Bypass Surgery: Risks
Journal of the American Medical Association: Atrial Fibrillation Following Coronary Artery Bypass Graft Surgery: Predictors, Outcomes, and Resource Utilization
British Medical Journal: Early Neurological Complications of Coronary Artery Bypass Surgery