1. After the bypass surgery, I need to have an MRI and CT examination because of other diseases, can they be done? Will it cause any harm to my body? Will it affect the test results? Many patients who have been discharged from the hospital ask if they can have MRI or CT examinations for other diseases. They are worried that the wires and temporary pacemaker leads in their bodies will not cause any harm to their bodies. Will it affect the test results? Please be assured that these tests can be done if needed, and that the effects on the body (especially the MRI, which has some thermal effects) will not cause any substantial harm to the body. There will be some artifacts on the quality of the imaging, but experienced doctors will not affect the diagnostic results. 2. Will angina and myocardial infarction not occur again after the bypass surgery? How long will the surgery last? What if the symptoms appear again in the future and the lesion of the non-bypassed vessel is found to be aggravated or the bridge is blocked again? The bypass surgery only solves the patient’s current myocardial ischemia problem, but does not completely cure the cause of coronary artery disease, so it cannot prevent the further development of coronary atherosclerosis, that is to say, after the bypass surgery, the original non-stenosed blood vessels and the bridged blood vessels may be stenosed or blocked again, resulting in the recurrence of angina. The time interval for restenosis varies from patient to patient, depending on the condition and degree of lesion of the patient’s coronary vessels, the quality of the saphenous vein used as bridge material, the combination of other underlying diseases, and the effectiveness of postoperative treatment for the cause of coronary artery disease (have you quit smoking?). Is weight control in place? Is the diet controlled? Whether or not hypertension, hyperglycemia and hyperlipidemia were well controlled). More recent findings point out that a significant number of patients are resistant to antiplatelet drugs such as aspirin and poliovirus, in other words, these two drugs, which are most critical for maintaining the usual rate of bridge distances, do not work in some patients. As a result, a very small number of patients may experience exacerbation of lesions in vessels not bypassed as well as stenosis or even occlusion of the bridge vessels just a few months after surgery. Therefore, after coronary artery bypass surgery, you should not have a relaxed attitude, thinking that your disease is cured and there is no more problem, so you can do whatever you want, and you can’t even insist on taking your medication. I often tell patients that bypass is like I helped you unclog the drain in your house, if you don’t pay attention to it in the future and still keep throwing dirty things into it, then we will meet soon. I hope that patients will pay enough attention to realize that the long-term effect of bypass has a lot to do with whether you can actively cooperate with the treatment after discharge. After discharge from hospital, you still need to take long-term medication and actively treat and control the susceptibility factors of coronary heart disease, such as smoking, excessive alcohol consumption, obesity, high blood pressure, high blood pressure and high blood sugar, which can effectively prevent the further development of coronary heart disease and avoid the recurrence of angina pectoris. If active treatment can be achieved, the vast majority of patients can live symptom-free high quality lives for quite a long time, even decades. It is generally believed that the 10-year patency rate of venous bridges is 50%, arterial bridges usually have a higher rate, and the long-term patency rate of intramammary artery bridges can even reach 95%. Why not all bridges are made with arterial material? Due to the limited number of arteries available for bypass in human body, and some arteries are not suitable for bypass because they are prone to spasm, lumen is too thin, difficult to take material with large damage or have lesions. Even if a blockage of the bridge vessel occurs, there is no need to worry too much, some patients have 4 bridges, post-operative blockage of 3, only one artery bridge is open, it is not necessarily life-threatening, or even no symptoms, and will not affect the quality of life. That is because there is collateral traffic between the three main vessels of the heart, and most of the own vessels or bridge vessels are in the process of chronic occlusion, during which more collateral circulation is established. Moreover, with the continuous development of medical technology, even if angina recurs, there are now corresponding treatment measures to cope with it, such as putting stents in the bridge vessel or operating again, which are possible, and the safety is not much increased from the first operation in a large heart center. 3. Will the leg bypass affect the function of the lower limbs? The saphenous vein, the longest superficial vein in the body, extends from the ankle to the base of the thigh. It is one of the most commonly used “bridge” vascular materials for coronary artery bypass surgery because of its small curvature, sufficient length, and matching caliber to the coronary artery. The human body has two sets of venous return systems in the lower extremities, the deep and superficial veins. Removing the superficial vein, that is, the saphenous vein, one set of return system is gone, which will inevitably cause venous return obstruction, that is why the lower extremity will be swollen after surgery, but because there are richer traffic side branches between the deep and superficial venous return system, after long enough postoperative recovery, the side branch circulation will be richer, and the deep veins can play a complete compensatory role, which will not have much effect on the venous blood return of the lower extremity. It will not affect the motor function of lower limb. However, there are some patients who cannot fully compensate for the function of the deep venous system, and the patients have long-term lower limb swelling, in this case, the patients need to insist on elevating the affected limb when sleeping for a long time, and insist on wearing medical elastic stockings when going down for a long time. 4. Why does the leg swell and go numb after taking the blood vessel? Sometimes there is cool fluid flowing from the wound? As mentioned in the previous question, since the saphenous vein is removed from the leg, the venous blood that originally needs to return through the saphenous vein needs to return through the deep veins to establish a new collateral circulation, and this process takes some time, usually several months. During this time, the lower extremity from which the vein was removed may experience varying degrees of swelling. Early in the procedure, the patient will need to elevate the lower extremity 20-750px while in bed to promote venous return to the lower extremity, reduce swelling and promote healing of the incision. If the edema is not eliminated for a long time, it can lead to malnutrition of the incision, non-healing, or even cracking of the incision due to excessive skin tension, leading to infection, etc. Patients with diabetes, in particular, should pay attention. Alternatively, use medical compression stockings, put them on when moving around on the floor and take them off after lying in bed, avoiding wearing them for a long time. In addition, since it is necessary to cut the skin as well as the subcutaneous tissue to obtain the saphenous vein, the nerves and lymphatic vessels in this area will be cut and damaged, so there will also be different degrees of numbness and other abnormal sensations after the surgery, which is normal and need not be worried. Sometimes there is a cool liquid flowing out from the wound because the thick lymphatic vessels are cut and the lymphatic fluid flows out, there is no need to worry too much, just do the corresponding treatment.