Bypass surgery is to create a shunt to bypass the narrowed section of a blood vessel. As a result, blood flow to the affected artery is restored. Normally, the inner wall of blood vessels smooth and level. However, in the development of atherosclerosis in the vessel walls are formed atherosclerotic plaques. They constrict the lumen of blood vessels and disrupt blood flow to organs and tissues. Over time, the vessel lumen is completely closed and blood flow stops. This in turn leads to necrosis.
Usually used in bypass surgery for coronary heart disease, in which the coronary arteries - the main blood vessels that feed the heart - are affected by atherosclerosis. However, bypass surgery and is used to restore blood flow in peripheral arteries (eg, in the arteries of the lower limbs).
Preparing for vascular bypass surgery
As to other surgical interventions, the surgeon performs a full interrogation of the patient, finds the complaint, their character, when they appeared, with associated, etc. After that the inspection. Feels the pulsation of the arteries. An important place in preparation for bypass surgery take special methods of investigation.
These methods include:
Duplex ultrasound scanning - a method to visualize the state of the lumen of blood vessels, the presence of plaque blockage and blood flow
Magnetic resonance angiography - a method that allows to see the lumen of blood vessels "in layers"
Angiography - a method of X-ray study of blood vessels, it lets you see the nature of the narrowing of blood vessels, the blockage, and this method is combined with the therapeutic manipulation (angioplasty)
In the accompanying diseases of the heart performed an ultrasound of the heart, coronary angiography (a type of angiography), and other methods. Indications for bypass vessels
If you have symptoms of atherosclerosis (coronary heart disease, atherosclerosis, peripheral arterial aneurysm, and others), you may be shown in shunt. Bypass surgery is also indicated when contraindicated angioplasty and stenting. What is the risk of complications during vascular bypass surgery?
Factors that increase the risk of complications during bypass surgery:
High blood pressure
High cholesterol in the blood
Coronary heart disease
Chronic obstructive pulmonary disease, such as emphysema
Engineering vascular bypass surgery
Typically, bypass surgery is performed under local or general anesthesia. When shunt vessels in the arm or leg is used as a shunt, usually subcutaneous thigh Vienna. Removal of the femoral vein with virtually no effect on blood flow in the lower extremity. Why are taken for bridging veins legs? The fact that the leg veins tend to be relatively "clean", not affected by atherosclerosis. In addition, these veins are larger and longer than any other available to capture the veins of the body. Sometimes, instead of the vein as a graft can be used by another Vienna or bypass of a synthetic material.
For aorto-coronary bypass grafting - a method of grafting, used in coronary heart disease, taken as a shunt artery. The most common and preferred bypass using the internal thoracic and radial artery. This provides a fully functioning shunt (its functionality and durability).
One of these arteries is the radial artery hands, it is located on the inner surface of the forearm closer to the thumb. In case you propose to use this artery, your doctor will conduct additional studies to exclude the appearance of any complications associated with the intake of the artery. Therefore, one of the incisions can be placed on the hand is usually on the left.
The surgeon makes an incision in the area of the damaged vessel. Once it identifies the affected vessel in places where it is supposed podshivanie shunt makes a small incision. Further shunt sutured to the ends of the vessel. Thus, blood flow is restored. After surgery, there are special methods of investigation, such as angiography, duplex ultrasound scanning to make sure that the shunt is installed successfully. Coronary artery bypass grafting
Varieties of coronary artery bypass grafting:
With the use of cardiopulmonary bypass
Without cardiopulmonary bypass using the "stabilizer" for the bypass
The use of minimal surgical incisions, including endoscopic surgery.
Postoperative period after bypass vessels
Usually after surgery the patient remains in hospital from 3 to 10 days. Sutures are removed from the wound after 7 days. The air will promote drying and healing of surgical wounds. The number and length of incisions on the legs in different patients may be different, depending on how much of the venous graft was planned to perform for you. Someone cuts are only on one leg, and someone at both, someone can cut on his hand. First you will clean the seams with antiseptic solutions, and make bandages. Somewhere in the 8 - 9 per day, with favorable healing, the sutures are removed, as well as a safety electrode is removed.
Later, you can gently wash the incision with soap and water. You can have a tendency to ankle swelling or burning feeling in the place where sections were taken of veins. This burning sensation will be felt when you stand or at night. Gradually, with the restoration of blood flow in veins field fence these symptoms disappear.
Complications of vascular bypass surgery
As after all other operations, after bypass surgery is possible, though rare, some complications such as swelling or inflammation in the wound area. Less common are bleeding from the wound, re-occlusion of the vessel, or shunt. Prevention of vascular disease
Preventing vascular disease is the prevention of risk factors, which have already been mentioned.