In **heart bypass surgery**, the patient's chest is opened and a healthy vein is removed from the leg, chest, or sometimes wrist to be used as a replacement for the blocked heart artery. This operation usually takes between 3 and 6 hours, and the recovery period lasts about 6 to 12 weeks for the patient to fully recover. heart bypass operation **Heart bypass operation** is usually used to **remove blockage in coronary arteries** and **improve blood flow** to the heart muscle. If one of your main arteries is blocked, the doctor may suggest this surgery as one of the treatment methods. In the following, we will talk about **what is heart bypass surgery**, who needs it, how it is performed, what are the pre- and post-cares, and what are the risks and complications. We also check the duration of this surgery. If you have **suspicious heart symptoms** or you have a **history of heart disease**, be sure to visit a **cardiologist** for more detailed examinations. He is **Dr. Doderes, a specialist in cardiology in Tehran**, you can apply for **online appointment booking**. **How is heart bypass surgery?** **Heart bypass surgery** is one of the **open heart surgery techniques**, during which an alternative route for blood flow is created around the **heart vessels** that are blocked. This method is often recommended for patients with coronary artery stenosis or blockage. **Decreased blood supply due to the narrowing of these vessels** can cause **chest pain** or other symptoms. In this surgery, the doctor separates a healthy vein from other parts of the body, such as the leg, chest or hand, and transplants it in such a way that the blood flow passes through the blockage and reaches the heart. One end of the new vein is connected above the blockage and the other below it. Keep in mind that **bypass surgery** does not completely remove the underlying problem of clogged arteries, but it reduces its symptoms such as chest pain and shortness of breath and reduces the risk of heart diseases. ### **This practice is also known by other titles, including** - **coronary artery bypass graft** - **Cardiac bypass surgery** - **action** > In this surgery, a part of a healthy blood vessel is removed from the chest or leg and a new path is created in the blocked part of the coronary artery. ### **When is there a need for heart bypass surgery?** **Heart bypass surgery** is performed when the blood flow to the **heart muscle** is severely reduced and other treatment methods such as medication or **angioplasty** cannot solve the problem. This procedure is often prescribed to **prevent heart attack** and as an effective treatment solution in acute conditions. This surgery is usually necessary in the following cases: - Severe blockage in the main artery of the heart, which is responsible for delivering a lot of blood to the heart muscle. - Significant stenosis or narrowing of the main artery of the heart. - The presence of several blocked arteries that cause chest pain even during rest or low-stress activities such as walking. - Dysfunction of the left ventricle of the heart that can reduce blood pumping power. - When the blockage is not removed by methods such as angioplasty (opening the artery with a balloon through a catheter) or the location of the blockage is not suitable for this procedure. > According to the heartandstroke site, in some special cases, doctors prefer to perform **bypass operation** instead of **angioplasty**; Especially if there are multiple blockages or the blockage is in parts of the vessel that the catheter cannot easily access, such as curved or twisted arteries. ### Symptoms of coronary artery disease Heart bypass surgery is performed to treat blockage or narrowing of arteries. The following symptoms can be a sign of **coronary artery disease**. - Chest pain - Extreme fatigue - Heart palpitations - Irregular heart rhythm - shortness of breath - Swelling of hands and feet - Indigestion ### **Which doctor should we consult to check the need for heart bypass surgery?** If you see symptoms of **heart disease** or have symptoms similar to a heart attack, you need to see a **cardiologist** as soon as possible. These specialists can decide on the necessity of bypass surgery after examination, tests and detailed investigations. **Dr. Dadres, a specialist in cardiology and echocardiography in Tehran, is ready to offer heart echocardiography services to patients**. ### **How is heart bypass surgery performed?** At first, the patient becomes completely unconscious with an anesthetic drug that is administered by injection or through a **breathing mask**. After that, a tube is placed inside the patient's mouth, which is connected to the **artificial breathing machine (ventilator)** and takes over the task of breathing during the surgery. If **bypass surgery** is of the on-pump type, **artificial heart and lung device** is used to supply blood to body parts. In this case, the patient's heart stops for a while so that the surgeon can do his work more easily. In some cases, the surgery is performed off-pump, where the heart remains beating. The duration of this surgery is usually between 3 and 6 hours and may be longer depending on the number of damaged vessels. To access the **heart vessels**, the surgeon makes a large incision in the center of the chest to reach the blocked arteries and bypass them. > Heart bypass surgery takes about 3 to 6 hours. The duration of the operation depends on the number of blocked vessels. ### Procedures of heart bypass surgery The **coronary artery bypass surgery** process usually includes the following steps: 1. First, the surgeon makes an incision along the breastbone to gain access to the heart. 2. After opening the chest, using special drugs, the heart stops beating temporarily. At this stage, the artificial heart and lung system takes over the task of pumping blood and providing oxygen. 3. Then, a portion of a healthy vein (from areas such as the chest, leg, or arm) is removed. 4. This vein is connected to the two ends of the blocked artery; One end above the obstruction and the other below it. In this way, a new path for blood flow is created. 5. If several arteries are blocked, multiple grafts may be needed at the same time, which increases the duration of surgery. ### Other types of heart bypass surgery In some patients, a different type of **bypass operation** is performed, which includes the following: - Off-pump bypass: In this type of surgery, the heart continues to beat and there is no need to stop it. Cardiopulmonary device is also not used. To perform this procedure, special tools are used to keep the area of ​​the heart that is being worked on fixed. Despite its advantages, this method is not suitable for all patients and is more difficult to implement. - **Minimally invasive heart surgery:** In this method, instead of a large incision in the chest, several small incisions are made. The surgeon guides the operation using special cameras and robotic equipment. This method has a shorter recovery period due to smaller incisions, but it cannot be used for all conditions. ### Important points before heart bypass surgery Before performing **heart bypass surgery**, it is necessary to be examined by a cardiovascular surgeon to check the necessary preparation for surgery. The doctor may talk to you about modifying some daily habits such as **diet, physical activities** and taking medications. Be sure to provide your doctor with all your medical records; including **allergies, diseases such as asthma, drug allergies or blood clotting problems**. If you have diabetes or kidney disease, or have recently experienced a change in your health, it is important to inform your doctor. If you are taking blood thinners, you may need to stop taking them a few days before surgery. From the night before surgery (usually from midnight), you should not eat or drink anything. Also, you will need someone to drive you home after the procedure, so it is better to arrange with a family member or friend in advance. If your operation is pre-planned and not an emergency, you will visit the hospital on the morning of the operation. In the days leading up to surgery, several tests, such as **blood tests, an electrocardiogram (ECG) and a chest x-ray**, will likely be done to check your overall health. Frequently asked questions ### Why does a person who has undergone coronary heart bypass surgery feel that his heart is burned? After **coronary artery bypass surgery**, you may feel pains on both sides of the chest that are similar to a burning sensation. This pain is usually **natural** and occurs due to the recovery and healing process of the body after surgery. Usually, these pains decrease and improve **4 to 6 weeks** after the operation. ### How long does heart bypass surgery take? Heart bypass surgery usually takes between 3 and 6 hours. The duration of the operation depends on the **number of blocked vessels**. The more vessels that are blocked, the more complicated the operation will be and the longer it will take. ### What is cardiopulmonary bypass? **cardiopulmonary bypass device** is used during heart bypass surgery. This device is used to deliver blood and oxygen to other organs during surgery when the heart stops beating. This device helps maintain blood flow and oxygen supply to the body to function during surgery. ### How long is the recovery period for heart bypass surgery? The recovery period of **heart bypass surgery** usually lasts **6 to 12 weeks**. This period of time can be different depending on the condition of the person and how he recovers. During this period, the person should take special care and gradually return to his daily activities.