Heart bypass surgery after a heart attack: what it is, indications and contraindications for preparation, as do

Talking about what is heart bypass surgery after a heart attack, you must specify the following: The operation aims to restore blood supply to the heart muscle. During the intervention created additional ways of blood flow necessary for the heart with oxygen and nutrients.

Indications and contraindications to

Coronary artery bypass surgery is indicated for heart attack, caused by:

• pronounced narrowing of the left coronary artery, in which the lumen diameter decreases by more than 50%;
• narrowing of a few large vessels (coronary arteries total diameter in this case does not exceed 30% of the normal index);
• LAD occlusion expressed vessel in its initial sections (in combination with other overlapping lumens of the coronary arteries).

If after a heart attack occurs angina, surgery helps reduce the risk of exacerbations. Surgical intervention is more effective than medication and minimally invasive techniques. In myocardial ischemia and eliminates bypass surgery restores the power of the heart muscle, so it can be used in the prevention of relapse. Contraindications for surgery are:

• most of the atherosclerotic lesion of the coronary vessels;
• a sharp drop in blood ejection until 30% of the normal value;
• expressed focal scarring lesions of the heart muscle;
• inability of the heart to pumping sufficient blood supply to the tissues of blood volume;
• severe concomitant diseases (acute renal and liver failure, decompensated diabetes, chronic obstructive pulmonary disease);
• late stages of cancer;
• old age (over 80 years).

Training

Preparation for CABG during a heart attack include:

1. Compliance with special diets. The last meal is carried out 24 hours prior to the intervention. On the day of surgery refuse to use liquid.
2. Preparation of the surgical field. Skin chest and the area of ​​the graft of the fence must be devoid of hair. Shaving is carried out on the day of surgery.
3. Colon Cleansing. On the evening before taking a laxative, before the intervention put a cleansing enema. After the procedure take a shower.
4. Cancel medicaments. Tablets are taken during the last food intake. The introduction of anticoagulants is stopped for 2 weeks prior to coronary artery bypass grafting.
5. Consultation of the surgeon and the anesthesiologist. The doctor performs inspection and formulate a plan of operation. At this stage revealed the existing patient allergic diseases.

How do

Shunting after infarction involves the following steps:

1. Premedication. The patient is administered sedatives, then it is delivered to the operating unit. Hands and human feet fixed on the operating table. The patient is connected to the apparatus, the recording of vital functions. Monitored heart rate, blood pressure, respiratory rate of muscle contractions and blood oxygen levels. The bladder catheter needed for removing urine.
2. Statement of anesthesia. The operation is performed under general anesthesia, requiring tracheostomy.
3. Providing access to the chest. The middle part of the chest is treated with antiseptic then dissected. The intervention is performed open-heart surgery.
4. Separation of the medial mammary artery. Performed at mammakoronarnom bypass.
5. Obtaining grafts. For this purpose, fragments of the femoral arteries. In some cases, synthetic grafts are used.
6. Connecting the heart-lung machine. Performed hypothermic cardiac arrest. If an intervention is carried out on a functioning heart, impose devices that disable some parts of the heart muscle at the site of the operation.
7. Installation of shunts. After insertion of the device resumes functioning cardiac muscle, lung machine is turned off.
8. Crosslinking of the surgical wound, the installation of the drainage tube.

Results and Recovery

Rehabilitation of patients after coronary artery bypass surgery include:

1. Stay in the ICU. Here, the patient spends 2-3 days. The first 24 hours of the patient is required to find on the ventilator. Here is the treatment of angina, which develops after a heart attack.
2. Providing ventilation. After the transition to the spontaneous breathing patient is given a rubber device that must be periodically inflated.
3. Caring for the operating wound. Dressings should be changed daily. Suture treated antiseptic. After 10-14 days, the wound heals, at this stage of renewed conduct hygiene procedures.
4. Wearing a breast-band. Sternum after surgery fasten plates and screws. Healing takes at least six months. During this period used medical corsets, supporting the chest in the correct position.
5. Elimination of anemia. Pathological condition develops because of blood loss during surgery. The diet is introduced iron-rich foods - beef, beef and pork liver, buckwheat, apples. Additional iron preparations used (Maltofer). The level of hemoglobin in the blood to normal in a month.
6. Increase physical activity. Start with a slow walk along the corridor. Walking speed increases daily. Distance traveled per day is gradually increased up to 1000 m.
7. Spa treatment. It accelerates recovery after bypass surgery, improving overall health.

In addition to the positive result, the operation could have adverse consequences. These include:

• the frequent occurrence of seizures, increases the probability of death;
• infection of the endocardial to the development of severe inflammation;
• cardiac dysfunction, accompanied by deterioration of blood supply and organ supply;
• arrhythmias of various types;
• inflammation of the pleural sheets caused by trauma or infection;
• increased risk of ischemic stroke.

For non-specific complications include conditions arising after any intervention, - bleeding, festering wounds operating thrombosis.