Double Bypass Surgery

zeta_evolved wrote: This is how it’s done:

1. The patient is brought to the operating room and moved onto the operating table.
2. An anesthetist places a variety of intravenous lines and injects an induction agent (usually propofol) to render the person unconscious.
3. An endotracheal tube is inserted and secured by the anesthetist or assistant (e.g. respiratory therapist or nurse anesthetist) and mechanical ventilation is started.
4. The chest is opened via a median sternotomy and the heart is examined by the surgeon.
5. The bypass grafts are harvested - frequent conduits are the internal thoracic arteries, radial arteries and saphenous veins. When harvesting is done, the patient is given heparin to prevent the blood from clotting.
6. In the case of “off-pump” surgery, the surgeon places devices to stabilize the heart.
7. If the case is “on-pump”, the surgeon sutures cannulae into the heart and instructs the perfusionist to start cardiopulmonary bypass (CP. Once CPB is established, the surgeon places the aortic cross-clamp across the aorta and instructs the perfusionist to deliver cardioplegia to stop the heart.
8. One end of each graft is sewn onto the coronary arteries beyond the blockages and the other end is attached to the aorta.
9. The heart is restarted; or in “off-pump” surgery, the stabilizing devices are removed. In some cases, the Aorta is partially occluded by a C shaped clamp, the heart is restarted and suturing of the grafts to the aorta is done in this partially occluded section of the aorta while the heart is beating.
10. Protamine is given to reverse the effects of heparin.
11. The sternum is wired together and the incisions are sutured closed.
12. The person is moved to the intensive care unit (ICU) to recover. After awakening and stabilizing in the ICU (approximately 1 day), the person is transferred to the cardiac surgery ward until ready to go home (approximately 4 days).

Now two coronary arteries will be bypassed (duh double bypass)
this can happen:

CABG (pronounced cabbage) associated

* Postperfusion syndrome (pumphead), a transient neurocognitive impairment associated with cardiopulmonary bypass. Some research shows the incidence is initially decreased by Off-pump coronary artery bypass, but with no difference beyond three months after surgery. A neurocognitive decline over time has been demonstrated in people with coronary artery disease regardless of treatment (OPCAB, conventional CABG or medical management).
* Nonunion of the sternum; internal thoracic artery harvesting devascularizes the sternum increasing risk.
* Myocardial infarction due to hypoperfusion, early graft occlusion, or graft failure.
* Late graft stenosis, particularly of saphenous vein grafts due to atherosclerosis causing recurrent angina or myocardial infarction.
* Acute renal failure due to hypoperfusion.
* Stroke, secondary to aortic manipulation or hypoperfusion.

General surgical

* Infection at incision sites or sepsis.
* Deep vein thrombosis (DVT)
* Anesthetic complications such as malignant hyperthermia.
* Keloid scarring
* Chronic pain at incision sites
* Chronic stress related illnesses
* Death

Dhem92 wrote:



Did you copy and paste that?

Cid wrote: How severe is a double bypass surgery? Anybody know?

NEREVAR117 wrote:

My mother, who is a nurse and trying to become a doctor. Says that it’s very severe, however, the surgery usually goes over well and is successful.