heart bypass surgery

Commonly known as coronary artery bypass grafting, it is the most internationally recognized method for treating coronary heart disease. Coronary artery stenosis in coronary heart disease is mostly segmental. And mainly located in the proximal segment of the coronary artery, the distal segment is mostly normal. Coronary bypass is the establishment of a pathway between the proximal and distal ends of a coronary artery stenosis that allows blood to pass through the narrow median to the distal end. Treatment of diseases: coronary heart disease Indication a. The angina pectoris is severe and the ability to work is ineffective. b. Coronary angiography, coronary artery stenosis more than 50% or branch stenosis more than 75% of the diameter, stenosis of the distal segment of the artery is smooth, and its diameter is more than 1.5mm. c. After myocardial infarction, coronary angiography showed significant coronary stenosis. d. Angina pectoris complicated with left ventricular aneurysm, or with ventricular septal defect or valvular lesion. Contraindications a. Left ventricular function is low, left ventricular ejection fraction is less than 0.2, left ventricular end-diastolic pressure is greater than 3kpa (20mmhg). b. Chronic heart failure, severe myocardial lesions, irreversible changes. c. Systemic diseases such as severe diabetes, hypertension, renal function or pulmonary insufficiency. Preoperative preparation Coronary angiography clearly identifies the location, extent and extent of obstruction. Patients with high blood pressure need to be treated with drugs to lower blood pressure to the normal range. Diabetes patients should be treated with medication before surgery. Patients with hyperlipidemia are given a low-fat diet and anti-hyperlipidemic drugs. If you have used digitalis, quinine to mark beta blockers, diuretics, anticoagulants, etc., should be discontinued 3 to 5 days before surgery. Patients with saphenous vein grafts should be prepared for a history of surgery, ulcers, varicose veins, and skin disease in the lower extremities. Surgical procedure Step 1: Cardiac bypass surgery Under local anesthesia, percutaneous right (or left) femoral artery puncture, after coronary angiography, a special balloon catheter is used to expand the lesion. Step 2: The balloon catheter with the stent is delivered to the lesion, and the stent is implanted with the balloon at 8 atmospheres for 30 to 60 seconds. Step 3: Use a high pressure resistant balloon, pressurize 12 to 16 atmospheres, and expand for 30 to 60 seconds to ensure uniform expansion of the stent. The stent will be permanently embedded in the intima of the patient's coronary arteries. In the bypass surgery, after the femoral artery sheath was inserted, heparin sodium was administered intravenously at 12 500 U. After each operation for 1 h, heparin sodium 2 500 U was administered intravenously, and the total amount was less than 20 000 U. In order to prevent intraoperative coronary spasm, 200-300 g of nitroglycerin was injected into the coronary artery before the stent was delivered and before the balloon was withdrawn. The risk and cost of bypass surgery is relatively large, and it can alleviate the symptoms of myocardial ischemia in a short period of time. However, arteriosclerosis is a systemic disease requiring systemic treatment such as blood pressure reduction, blood lipid regulation, anticoagulation, and dilatation of coronary vessels. , oxygen, etc. complication If the risk factors for the onset of coronary heart disease are not controlled, whether it is stenting or bypass surgery, new vascular lesions and new vascular stenosis may occur several years later.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.