How coronary heart disease is treated surgically

At present, the incidence of coronary heart disease in China is rising sharply, while the age of onset is decreasing. Some middle-aged people who have changed their habits and lifestyles are entering the emergency room because of acute myocardial infarction, and there have even been tragedies in which people have died before arriving at the emergency room. According to the World Health Organization, it is estimated that around 2020, our country and other developing countries will see the peak of the coronary heart disease “epidemic”. In the long evolutionary process of human life, and the heart this extremely important pumping function, compared to the heart’s own blood supply system – the coronary arteries appear quite fragile. Coronary heart disease is a direct threat to people’s health and even life from two aspects: angina pectoris and myocardial infarction after the resulting cardiac insufficiency, heart failure will seriously reduce the patient’s quality of life, cardiogenic shock often caused by the patient’s death; ischemic myocardium often affects the heart’s normal rhythm, resulting in ventricular tachycardia, ventricular fibrillation, etc., directly threatening the life of the arrhythmia. Coronary heart disease is a treatable disease. Many doctors compare coronary heart disease to a “landmine” buried in the patient’s body, not knowing when the patient will step on the “landmine”, and once stepped on the “landmine”, that is, acute myocardial infarction or sudden death. Once stepped on, acute myocardial infarction or sudden death occurs. Coronary artery bypass grafting can successfully remove this “landmine” and remove the threat to the patient. Coronary artery bypass grafting is also known as “coronary artery bypass grafting”. It is to take a vein or artery from the patient’s body that does not affect the physiological function, one end is connected to the root of the aorta, and the other end is connected to the distal end of the coronary artery lesion, which just bypasses the diseased part of the coronary artery, and reaches the distal myocardium like a “bridge”. It is a bridge to the distal myocardium, relieving the symptoms of coronary artery disease, preventing sudden coronary death, and improving the quality of life for patients with coronary artery disease. Coronary artery bypass grafting can not only solve the problems faced by drug therapy and percutaneous puncture coronary stenting in the treatment of coronary heart disease, such as coronary artery branch lesions, multi-branch lesions, unprotected left main lesions, etc., but also is the most thorough and complete way of blood flow reconstruction. Patients can return to normal work in 1-2 months after bypass surgery, and the elimination rate of early angina symptoms is as high as 85%-95%, more than 65% of patients are angina-free for 5 years after surgery, and the 5-year survival rate is 93%, and the 10-year survival rate is 80%. Even if 3 coronary arteries are diseased with impaired cardiac function, the 7-year survival rate can be up to 90%, while only 37% of the patients are treated with medication alone. In the past, the saphenous vein was used as the bridge vessel, but with the improvement and development of surgical techniques and instruments, arteries with higher long-term patency and survival rates and better prognosis such as internal mammary arteries and flexor arteries are now used as the bridge vessel. People are generally worried about coronary artery bypass surgery. In fact, former Russian President Boris Yeltsin and former U.S. President Bill Clinton underwent coronary artery bypass grafting surgery, which shows that the development of the procedure has reached the peak of excellence. And now we have developed minimally invasive coronary artery bypass grafting with small incisions and without stopping the heart, i.e., coronary artery bypass grafting under non-corporeal circulation, and the results are satisfactory. Coronary artery bypass grafting under non-corporeal circulation is not a new concept, and as a minimally invasive surgery, it has been carried out more and more widely in the 1990s. This procedure has the advantages of less trauma, fewer complications, quicker postoperative recovery and lower medical costs, and at the same time enables patients with contraindications to extracorporeal circulation to receive effective treatment. With the introduction of various new cardiac stabilizers and improved methods of vessel exposure, the majority of procedures (>90%) can be performed non-corporeally by experienced surgeons. We are now able to routinely perform cardiac coronary artery bypass grafting on our own, and have developed minimally invasive non-corporeal surgery, which expands the indications for the procedure, reduces the pain of the patient, and results in better patient outcomes after the procedure, eliminating the need for such patients to travel outside of their home country for treatment. Coronary artery bypass grafting surgery needs to change the bad habits after surgery, such as smoking, alcoholism, high sugar and high fat diet, etc., must control some underlying diseases such as diabetes, hypertension, etc., adhere to the drug treatment, moderate exercise to ensure that the vascular bridge is smooth.