Atherosclerosis is the main cause of ischemic heart disease. It is caused by the build-up of fat, calcium, and cholesterol on the walls of coronary arteries. As a result, the coronary arteries become thickened, narrow, and lose elasticity. If not diagnosed and treated in time, atherosclerosis may lead to the blockage of the blood flow through the arteries. This may cause an acute myocardial infarction (heart attack), stroke, or even death.
One of the options to treat heart disease is coronary bypass surgery. Coronary bypass surgery restores blood flow to the heart muscle by diverting the flow of blood around a section of a blocked artery. The surgery creates a new path for blood to flow to the heart thereby improving the blood flow to the heart.
The Cardio Surgical Department at Tel Aviv Sourasky Medical Center (Ichilov) performs nearly 4,000 coronary bypass surgeries annually.
Coronary bypass surgeries are performed in the following cases:
- Stenosis of the three main coronary arteries
- Significant stenosis of the left main coronary artery
- Severe left ventricle dysfunction
- Joint valvular and arterial dysfunction
Some patients may be referred to coronary bypass surgery after having suffered from myocardial infarction, when the arteries are already blocked and when catheterization and opening of the artery is no longer an option.
Coronary bypass surgeries are performed at Ichilov Hospital under general anesthesia and usually take 3-4 hours. Prior to surgery, the patient will receive tranquilizers in order to relieve anxiety.
There are several bypass surgery methods:
- Traditional open-heart surgery, whilst connected to the heart-lung bypass machine.
- The new “beating- heart” procedure, without being connected to the heart-lung bypass machine.
- Minimally invasive coronary artery bypass surgery, without opening the chest. This method is used for the left anterior descending artery bypass.
The Surgery Success/Risk Rates
Bypass surgeries at Ichilov Hospital are performed by two surgeons. The bypass grafts are usually taken from arteries in the hips or chest. The vascular surgeon will replace all the blocked arteries during the surgical procedure. If the surgery is performed using the heart-lung bypass machine, the patient will be disconnected from the machine as soon as the heart regains its normal functioning.
Bypass surgery success rates are very high. Most patients who had the coronary bypass surgery performed at Ichilov acknowledge that their quality of life has significantly improved and enjoy the results of the bypass surgery for many years to come.
The risk of complications after bypass surgery is minimal. A higher risk of complication may be observed in patients with coagulation disorders, inflammatory responses, and chronic kidney diseases. Patients suffering from chronic pulmonary diseases or left ventricular dysfunction also have a higher risk of possible complication.
The Healing Period
The healing process usually takes up to 6 weeks. You will be able to resume normal activity about three weeks after surgery. You will be expected to return to the hospital for a follow-up visit 2 weeks after the surgery.
Ichilov Hospital cardiologists encourage their patients to join rehabilitation programs for patients with heart disease. The rehabilitation period is patient-specific and depends on the general well-being of the patient prior to the coronary bypass surgery, their age, and history of chronic diseases.