Many patients with heart-attack symptoms can be treated with catheter-based intervention, in which a catheter is passed through an artery to the heart, a balloon is used to open the blocked artery, and a metal stent is placed to keep the artery open. But a good percentage of patients for whom catheter-based intervention is not feasible can be treated with coronary artery bypass graft surgery.
During bypass surgery, the diseased sections of coronary arteries are bypassed with healthy artery or vein grafts to increase blood flow to the heart muscle. The surgery requires opening the chest and usually involves a five- to seven-day hospital stay, followed by weeks of recovery.
Patients likely to require bypass surgery have blockages in multiple vessels. The same goes for diabetic patients who often have smaller vessels, or patients who have a blockage in a single vessel in a location hard to reach with a catheter.
Before surgery, it is important for patients to be aware of a hospital's experience with performing open-heart surgeries. The Society of Thoracic Surgeons, a non-profit organization representing more than 6,000 surgeons, maintains an adult cardiac surgery database to which participating hospitals submit heart surgery data. Patients who have surgery at a hospital with a three-star rating from STS can be assured that they are receiving the best care from one of the nation's leading heart programs.
Because bypass-surgery patients often have medical conditions that slow or interfere with their recovery, they might require a brief stay in a rehabilitation center after discharge from the hospital. All bypass surgery patients are encouraged to participate in an outpatient cardiac rehabilitation program, which helps participants ease back into exercise while being monitored.
Complication rates and mortality rates with elective bypass surgeries have decreased to between 1 percent and 2 percent, due to technical improvements and advances in medical care.
Bypass surgery patients can significantly decrease their chances of having future heart problems by making lifestyle changes, such as eating a well-balanced diet, getting regular exercise, quitting smoking and keeping blood sugar, cholesterol and blood pressure well-regulated. Regular checkups with a primary-care physician or cardiologist are also crucial to long-term survival.
Dr. Anthony Rogers, a cardiothoracic surgeon with Cardiovascular & Thoracic Associates, is medical director of cardiothoracic surgery at Central Baptist Hospital.