Bypass grafting (CABG) surgeryis performed to restore the normal blood flow in the arteries of the heart muscle. Impaired blood flow as a result of CHD is returned to normal operation specialized. Performed surgery to arrange an alternative vascular path. The procedure is called, in accordance with the applicable anastomosis - shunts that puts the doctor.
Indications for coronary bypass in Assuta
The operation is performed under the following violations:
- In patients with ischemic myocardium and dysfunctional experiences with medication.
- In patients with refractory angina clearly manifested where the indications for CABG are designed to improve long-term prognosis.
- The people who will be an operation on the heart muscle. Here CABG is indicated for the additional support of the heart.
According to the method of distinguished 3 types of intervention:
- Operation with the use of a unit supporting an artificial blood circulation. During the procedure, the surgeon gains access to the heart muscle, which performs a functional working equipment. Vascular surgeon convenient to carry out manipulations on an irreducible heart. After the intervention of the body starts in the standard mode, so that the doctor was able to disable the device used.
- When a coronary artery bypass surgery without stopping the heart is shown. For the operation applies stabilizer myocardial tissue.
- medical intervention with minimal surgical trauma (minimally invasive access), including with the use of endoscopy.
The final choice of strategy of the operation is determined based on the results koronarograficheskogo study and evaluation of the expert opinion of relevant doctors. The account is taken severity of coronary artery disease, age of the patient, presence of concomitant diseases, the risk of complications and other factors.
Coronary artery bypass surgery is performed on the testimony in the clinic Assuta :
- Angina high functional class - in this state the patient is unable to cope with basic household needs, the smallest loads cause serious deterioration of health. It is satisfied if the stent is not able to ensure a favorable outcome.
- Progressive angina - a common load gives a more intense, prolonged and frequent attacks.
- In lesions 3 coronary arteries (helps to identify plugging coronary vessels).
- Aneurysm of the heart - when stretched vein wall or the heart muscle bulges. Condition laden with coronary atherosclerosis.
CABG indications include blockage of the left coronary artery in the case of lesions by more than 50%, the weight coronary vasoconstriction than 70%, significant stenosis of the arteries.
Multifocal arterial disease, complicated by an abnormality of the heart muscle (malformation, aneurysm) requires intervention operable using cardiopulmonary bypass. Surgery on the beating heart is performed in patients with vascular disease, with severe plaques in the aorta. It is recommended not to stop the work of the heart muscle in stenosis of the carotid artery, renal failure, transient ischemic attack, complicated functions of the respiratory system. The share of such procedures accounted for 20% of the total.
Minimally invasive endoscopic method well-proved itself during transplantation left internal mammary artery to the left anterior descending. The Israeli medical institutions have built up extensive experience in conducting operations on the heart muscle, is used robotic surgery, when high-precision equipment performing CABG in a closed chest through minimal incisions tissues. During the operation makes a small incision of the chest. The recovery period is faster, remain slight traces. wound infection risk is negligible, there is less blood loss. Length of stay in hospital is short. With a favorable state of health of the patient to go home after 3 days.
Patients often ask about bypass surgery - is it possible to carry out the operation in hypothyroidism. In old age, the combination of thyroid and cardiac disease is common. When combined coronary artery disease and hypothyroidism difficult to use replacement therapy. treatment adopted in medical practice thyroxine entails aggravation of myocardial ischemia due to coronary artery stenosis. Coronary angiography confirmed the diagnosis requires the use of coronary artery bypass grafting.
Contraindications to CABG
There are several contraindications in which the operation is impossible. Among the factors mentioned:
- Heavy state of the sick person, old age, when the forecast is unfavorable to the surgery because of the risk of aggravation of the situation and the possibility of death.
- Incurable disease history. Critical evaluation obtained neoplasm oncological nature, abnormal growth of lung, liver and kidney failure, uncontrolled hypertension.
- Recent stroke, which can cause a relapse during the operation.
- Multifocal and extended stenosis, affecting the large arteries and small vascular net.
- Extremely low ability to reduce left ventricular myocardium.
In the past, acute myocardial infarction, was considered an absolute contraindication to CABG, today the situation has changed. Taken into account the physician's assessment, guiding the operation. Besides the above states coronary artery bypass has relative contraindications type. They ranked uncompensated diabetes mellitus type obesity.
Carrying operable intervention proven clinic - the key to a successful outcome of the event. The condition of patients after surgery on the arteries release stagnation and heavy plaque is improved in the future remains stable. In the case of atherosclerosis reoperation advised when deterioration. According to medical statistics interoperable period in these cases is from 5 to 12 years.
The Assuta medical examination and treatment by experienced doctors, the successes are known worldwide. Modern equipment, qualified personnel, advanced methods of therapy - these factors reduce the risk of undesirable forecast to a minimum. Careful evaluation before surgery leads to the conclusion about the need to ban or surgery. In certain cases, the relative contraindications are not an obstacle on the road to health.
It is important to understand that CABG relieves the patient, gives him a prolonged period of remission, but does not eliminate completely from coronary heart disease. After surgery, the doctor gives the patient a detailed plan of regulations, compliance with which is strictly necessary. Individual rehabilitation program helps to longer maintain the effect of the distance treatment.