The Enid News and Eagle, Enid, OK

Enid Features

January 9, 2013

Having heart surgery — emergency and otherwise

Edward told the doctor he had been “a little short of breath” while working in the garden recently; “I just want to check things out to stay on the safe side,” he said.  It didn’t take the doctor long to discover that Edward was on the far side of safe. He was told to report to the hospital the next day for open heart surgery. That was 15 years ago, when Edward was a mere 82; he is still walking around today at age 97.

About 500,000 Americans undergo coronary artery bypass graft surgery every year. Some are in the middle of a heart attack when surgery is performed; others are considered at high risk because of significant narrowing of the arteries that provide blood flow to the heart.

The narrowing may occur gradually over many years, but when 50 to 75 percent of the vessel becomes blocked, the patient is likely to experience symptoms such as chest pain or shortness of breath when exercising or performing daily activities. This occurs because not enough oxygen-rich blood is getting through the blood vessels to meet the needs of the heart.

When coronary artery disease is detected early enough, it can be treated with lifestyle changes (diet and exercise) and medication. But when blockages continue to get worse despite these measures, more invasive approaches such as balloon angioplasty or coronary artery bypass graft surgery (CABG) may be necessary.

The name tells it all: blood flow through the coronary artery is restored by taking a graft from another, non-diseased blood vessel and suturing it into the coronary artery to bypass the blockage. You’ve probably heard of double, triple, quadruple or even quintuple bypass surgery — depending on how many arteries near the heart are blocked and how many are repaired. The procedure is complex and time-consuming, requiring about three to six hours in the operating room.

To reach the heart, the surgeon makes an incision down the middle of the chest and then saws through the breastbone. The main aorta is clamped off, and the pumping action of the heart is taken over by a heart-lung machine.?

Traditionally, the blood vessel graft was nearly always taken from the saphenous vein in the leg. Recently, doctors have preferred to use chest wall arteries such as the left internal mammary artery. These are not only nearer and easier to connect but also have been found to remain open longer after surgery. Ten years later, 90 percent of these grafts are still open, compared to only 66 percent of vein grafts.

After the grafts have all been sutured in place, the breast bone is wired together and the incision is sewn shut. Complications such as bleeding or irregular rhythms can occur in the first few days after surgery; even so, the average length of stay has been reduced to three or four days for most patients.

More serious complications can occur in the days or weeks after surgery — heart attack, stroke, memory loss, confusion, infections and death. Many of these complications occur as a result of stoppage of the heart.

To address these problems, off-pump bypass surgery was developed and is now used for about 20 percent of cases. Using suction or compression, the surgeon can stop only a small portion of the heart, allowing the beating to continue. This approach is at least as effective as traditional surgery and has been linked to fewer short-term complications. Some patients are better suited than others to off-pump surgery, however.

Another advance is minimally invasive heart bypass surgery (known as “keyhole” surgery), performed through a three-inch incision.

For a heart attack in progress, either angioplasty or CABG, performed in an emergency environment, is now considered an effective option for quickly restoring blood flow through coronary arteries. Although angioplasty is quicker, less invasive and carries fewer risks, bypass surgery is usually favored for patients with narrowing of the left main coronary artery or narrowing of three or more vessels. Diabetes patients may also do better with surgery. In some cases, too, emergency angioplasty fails, and bypass surgery must be performed as a backup life-saving measure.

Overall, about three to four percent of patients undergoing bypass surgery die, either during the procedure or shortly thereafter — most commonly because of a heart attack. It is not a procedure to take lightly; and it rarely is. When coronary arteries are narrowed by 90 percent or greater — as in Edward’s case — or when they are completely blocked — as in a heart attack — it can save lives.

Rupp is a certified information and referral specialist on aging for NODA Area Agency on Aging. Contact her at 237-2236.

1
Text Only
Enid Features
  • Judy rupp.jpg Top 10 foods you can eat for longevity

    Top 10 lists are always fun. And what better topic than foods that will help you live a longer, healthier life?

    April 23, 2014 1 Photo

  • Vculek, Verba.jpg Vculek, 90

    Verba Jane Vculek will celebrate her 90th birthday with an open house from 2-4 p.m. Sunday, April 27, 2014, at the Marshall Alumni Hall on Main Street. Cards may be sent to 25199 N. Rockwell Ave., Marshall, OK 73056.

    April 22, 2014 1 Photo

  • peggy goodrich.jpg What's in a name?

    This dessert has a strange name and may deter you, but it is easy to make and fun this time of year.

    April 22, 2014 1 Photo

  • Crabbs, Thelma.jpg Crabbs, 102

    Thelma L. Crabbs will celebrate her 102nd birthday with family. Cards may be sent to Greenbrier Assisted Living, 1217 E. Garriott, Room 102, Enid, OK 73701.

    April 21, 2014 1 Photo

  • Jessica Nickels Sun. Life mug.jpg Extension helped start school lunch program

    Nutrition is constantly a hot topic, and we as Extension educators are always educating consumers on new research as it is available.

    April 19, 2014 1 Photo

  • Datebook for 4/20/14

    April 19, 2014

  • Judy rupp.jpg Wear shades and save your eyesight

    April 16, 2014 1 Photo

  • peggy goodrich.jpg Are you hungry for knowledge?

    I am so pleased that Enid and other cities are offering “Lifelong Learning.” It consists of classes on current events, art appreciation, psychology, our government and other interesting topics.

    April 15, 2014 1 Photo

  • denny.krick.80th.jpg Krick, 80

    Dr. Denny Krick will celebrate his 80th birthday in Branson, Mo., from April 17-21. Cards may be sent to 2610 Indian Dr., Enid, OK 73703.

    April 15, 2014 1 Photo

  • Mary.Oller.90th.jpg Oller, 90

    Mary Oller will celebrate her 90th birthday with family on Saturday, April 19. Cards may be sent to 3219 W. Cherokee, Enid, OK 73703.

    April 15, 2014 1 Photo

Featured Ads
AP Video
US Proposes Pay-for-priority Internet Standards Wife Mourns Chicago Doctor Killed in Afghanistan FDA Proposes Regulations on E-cigarettes Kerry Warns Russia of Expensive New Sanctions Mideast Peace Talks Stall on Hamas Deal Cody Walker Remembers His Late Brother Paul Grieving South Korea Puts Up Yellow Ribbons Raw: Kerry Brings His Dog to Work Raw: Girls Survive Car Crash Into Their Bedroom Three U.S. Doctors Killed by Afghan Security Yankees' Pineda Suspended 10 Games for Pine Tar Colleagues Mourn Death of Doctors in Afghanistan Ukraine Launches Operation Against Insurgents Obama Reassures Japan on China Raw: Car Crashes Into San Antonio Pool Time Magazine Announces Top Influencers List Raw: Angry Relatives Confront SKorea Officials Bigger Riders Means Bigger Horses Out West Yankees Pineda Ejected for Pine Tar Deadly Fungus Killing Bats, Spreading in US
NDN Video
Grumpy Cat Not Impressed at "Idol" Is Shaquille O'Neal the World's Best Ex-Athlete? Raw: Obama Plays Soccer With Japanese Robot Behind The Tanlines Jersey Strong Part 2 BASE Jumpers Set World Record Screaming 2-year-old gets psyched at Penguins game Pineda: Put pine tar because he didn't want to hit anyone Beyonce on Her Biggest Influence Michael Strahan's First Day on "GMA" Clerk catches on fire after man throws Molotov Cocktail into Brooklyn store Amazon's Deal With HBO Leapfrogs Streaming Rivals Stephen Colbert Tells David Letterman His Plan for 'Late Show' Georgetown police officer filmed tripping students Viral: It's Not Pitbull - It's Amy Poehler! Recycling Highlights for Earth Day Lupita Nyong'o Named People's 'Most Beautiful' Peeps Launched into Outer Space NYPD's Twitter Request For Photos Backfires New HBO Go Commercials Capture Awkward Family TV Watching Raw: Leopard Bites Man in India
House Ads
Comics