Triple coronary bypass: the details of the operation

What is the definition of coronary bypass?

Coronary bypass refers to heart surgery. This consists of create a “bridge” to bypass one or more blocked parts of the artery, and restore normal blood flow to the heart. The coronary arteries are divided into many branches, which explains why the bypass can be single or multiple depending on the number of lesions to be treated.

When is a triple coronary bypass done?

Coronary bypass surgery is recommended by the cardiologist to treat strictures coronary arteries (narrowings of the coronary arteries). These narrowings occur when the arteries aret clogged with fat deposits whose main risk factors are high cholesterol, smoking, diabetes and obesity. Coronary bypass surgery also allows prevent heart attacks and increase life expectancy. This intervention is proposed when the lesions of the arteries cannot be treated by drugs, and when it is not possible to resort to angioplasty (dilation of the arteries) or to the placement of a stent (device to widen the artery).

Why do we speak of a “triple coronary bypass”?

Receiving a triple bypass surgery did not no link with the severity of the pathology. It is indicated in case of multiple stenoses to bypass: three in the case of triple bypass. Note that coronary bypass surgery can also be single, double, quadruple, or even quintuple.

“To perform coronary bypass surgery, the surgeon removes the mammary arteries (located behind the sternum), the saphenous veins (in the leg) or the radial artery : it uses them to create one or more deviations from the aorta artery to the healthy part of the coronary artery”, explains Prof. Francis Junthier, thoracic and cardiovascular surgeon. The use of arteries is favored because of their greater durability. intervention requires an opening in the sternum in order to access the heart and arteries. Once the grafts have been removed, the surgeon establishes an extra-corporeal circulation (ECC) using a machine, in order to temporarily replace the work of the heart and lungs. He then proceeds to the bypass by implanting the vein or artery taken between the aorta and the part located downstream of the obstruction. The intervention takes place under General anaesthesia and depending on the number of bypasses to be performed, usually lasts between 2 and 5 hours.After coronary bypass surgery, the patient remains between 24 and 72 hours in intensive care for close monitoring. A hospitalization ofone to two weeks is necessary.

What are the risks of complications?

Although the operation is heavy, complications are rare. “Serious complications are between 1 and 3%, says Professor Junthier. They are identical to those of other cardiac surgeries: bleeding, stroke, infection, kidney failure, heart attack. Advances in intensive care anesthesia have made it possible to significantly limit post-operative pain.”

How long does recovery take after bypass surgery?

It is on average one to two months. A follow-up must be set up with the cardiologist, with regular visits once or twice a year. To prevent further narrowing, medical treatment will be implemented (anti-platelet agents, beta-blockers, ACE inhibitors and cholesterol-lowering agents). At the same time, it is essential to adapt their lifestyle :

• practice of a physical activity (walking or cycling),
• healthy and balanced diet,
• weight loss if necessary
• smoking cessation.

When can we return to work?

The duration of the work stoppage is usually 3 monthsit can be reduced in the case of office work or increased in the case of manual work.

What is the life expectancy after a triple bypass?

It cannot be encrypted. “But coronary bypass surgery is the only invasive therapy that has proven its effectiveness. to extend the life expectancy of patients with coronary artery disease, says the professor. This benefit is all the greater when the comorbidities are significant (diabetes in particular) and the coronary disease severe.

Thanks to Pr Francis Junthier, thoracic and cardiovascular surgeon.