What is coronary artery bypass grafting

  There are two types of surgical treatment for coronary artery disease: “stenting” and “bypass”. For single-branch, limited lesions of coronary arteries, stent implantation can be chosen, which is less invasive and faster recovery. Coronary artery bypass grafting is an effective treatment for patients with multivessel coronary artery lesions, diffuse lesions, and combined valvular lesions and ventricular wall tumors. However, due to the lack of understanding and fear of bypass surgery, many patients choose to abandon the procedure, which is very unfortunate. In fact, excluding anesthesia and extracorporeal circulation, it usually takes only 6-7 minutes for the surgeon to build a “bridge”.  Before surgery, coronary angiography must be done to clarify the site and degree of coronary artery stenosis, according to determine the number and location of bypass bridges. Echocardiogram, electrocardiogram, pulmonary function, liver function, kidney function and urinary and fecal routine tests are also done to understand the functional status of all organs of the body. In addition, strict control of infection, discontinuation of aspirin and other drugs, practice of abdominal breathing, avoiding excessive mental tension, etc. are also required before surgery.  Coronary artery bypass grafting is to take a section of autologous saphenous vein or other blood vessel located in the leg and make a bridge between the aorta and the distal end of the blocked lesion of the coronary artery, so that blood from the aorta is supplied to the distal end of the coronary artery through the grafted vessel to restore the blood supply to the corresponding myocardium, improve the ischemic state of the myocardium and relieve the symptoms of angina pectoris. Simply put, a channel is created between the proximal and distal ends of the coronary artery stenosis to allow blood to bypass the stenosis and reach the distal end.  Coronary artery bypass surgery is required for stenoses greater than 70% in two or more coronary arteries. Patients who have undergone coronary angioplasty and have stents installed in their coronary arteries will also require prompt bypass surgery if angina occurs again. This will not only eliminate angina and enable the patient to live and work normally, but also prevent myocardial infarction and sudden death.  Coronary artery bypass grafting has an “immediate” effect on the relief of angina pectoris. Many patients are able to walk up and down stairs within a few days of coronary artery bypass grafting. If they recover well, they can walk down the street a week later. 1-2 months after surgery, they are able to perform light work. 3-4 months after surgery, basic recovery.  It is important to note that an important factor affecting the outcome of coronary artery bypass grafting is the preoperative cardiac function status. Patients with angina pectoris should go to the hospital as soon as possible, do not wait until the occurrence of myocardial infarction to think about “bypass”, because by then there are too many myocardial cells necrosis, will bring difficulties to the recovery after surgery.