Coronary revascularization surgery, or a “coronary bypass,” is required when the heart's native arteries (the arteries that supply the heart with blood) become obstructed due to coronary artery disease. The surgery consists of rebuilding new vessels for the heart using grafts. These new vessels are made from a segment of saphenous vein (a superficial leg vein) or internal mammary artery (a small artery below the breastbone).
Surgery is necessary when the patient's angina can no longer be treated with coronary angioplasty (balloon dilatation and coronary stent placement) or medication.
Patients are admitted the night before or the morning of the procedure. The hospital stay is from 5 to 7 days and subsequent recovery time is approximately 3 months.
The MHI will contact surgical patients at home to plan a pre-admission meeting. If you are unable to attend one of these meetings, you can still get a lot of useful information about your procedure in the MHI's Heart Surgery: Patient's Handbook. If you have concerns before the surgery, you can contact the nurse working with your surgeon at 514-376-3330, extension 4062.
For this procedure, patients must be hospitalized in the Surgical Unit the night before the procedure or must arrive early the morning of the operation. The required exams are as follows: blood work and biochemical analysis, coronary angiography, chest X-ray and, if required, cardiac ultrasound and cardiac CT scan.
On the day of the surgery:
• You must be in a fasting state as of midnight the night before.
• A member of the care team will shave the required areas of the body.
• After being shaved, patients must wash with a disinfectant soap and put on a new hospital gown.
• The nurse will give patients their normal medication as well as medication to help them relax. The nurse applies a nasal cannula to administer oxygen.
• A patient service associate takes the patient to the operating room, where a specialist administers anesthesia.
The coronary artery bypass surgery normally involves putting patients on heart-lung bypass and stopping the heart so that the surgeon can conduct the procedure. The surgery may also be done without putting patients on a heart-lung machine. This type of surgery is called “off-pump bypass” or “beating heart” surgery. Using specialized instruments, the surgeon can stabilize the heart; however, it will continue to beat as the doctor creates the bypass.
After the surgery, patients are transferred to intensive care for 24 to 48 hours. Visits to intensive care are limited to one person for 5 minutes on the day of the surgery and for 15 minutes on the hour starting from 11:00 a.m. the next day.
After this period, patients are then transferred back to the Surgery Unit for 4 to 5 days. In this unit, patients can have visitors during normal visiting hours.
During the 3-month recovery period, patients can remain active and go back to their normal routine; however, strenuous activities must be limited. Early mobilization and daily physical activities are encouraged.
The main side effects are weakness and loss of energy after the surgery, which will gradually decrease as normal activities are resumed.
A follow-up visit with the surgeon is scheduled for 3 months after the surgery. Patients then see their cardiologist and family doctor for long-term follow-up.