Triple bypass surgery is a form of coronary artery bypass grafting (CABG) surgery. CABG is the most common type of heart surgery performed on adults. Triple bypass simply refers to the number of ships being bypassed (three). Using a thoracotomy technique, the surgeon delivers three blood vessels to the heart and surrounding area to bypass the damaged blood vessel.
By understanding what happens before, during, and after triple bypass surgery, you can increase your chances of success.
The day of triple bypass surgery can be hectic and overwhelming. If surgery is planned, you will have more time to prepare mentally and physically for the surgery. In the case of an emergency, preoperative examinations are very time-sensitive and multiple examinations may be performed at the same time.
On the day of surgery, you will meet with the entire medical team, including cardiothoracic surgeons, cardiologists, anesthesiologists, perfusionists, operating room nurses and other surgeons as needed. All surgical consent forms will be signed at this time to ensure you are fully prepared and do not have any other questions or concerns.
Registered nurses will take vital signs Include:
- heart rate
- blood pressure
- pulse oximeter
- blood sugar
- pain level
Before entering the operating room for surgery, the patient will preoperative examination complete. This will include:
- Electrocardiogram (EKG or ECG)
- sweaty work
- chest x-ray
- Carotid Ultrasound
- Pregnancy test (if required)
you will also get a surgical soap Must be used at the surgical site to properly clean the area and prevent infection. After cleaning, you will be given a hospital gown and the nurse will shave the surgical area for you if needed. When fully prepared, the surgeon will mark the surgical site.
The nurse and surgical team will review your medications. Be prepared to discuss all of your medications, vitamins, and supplements at this time, including dosage, last dose, and how often. It is helpful to provide a list of information so nothing is left out.
Instruct the patient to empty the bladder before entering the operating room and ask the patient to remove all jewelry, glasses, contact lenses, and dentures (if applicable).
Finally, the nurse will insert an intravenous catheter (IV) to provide hydration, medication, and anesthesia during the procedure.
When it is time for surgery, you will be carried into the operating room on a stretcher and placed on the operating table. Then, you’ll be ready for general anesthesia, which will continue throughout the procedure. Before the operation begins, the following will happen:
- You will be given small doses of medicine to help you relax while the surgical team prepares.
- A vital signs monitor was placed.
- Your skin will be cleaned again with surgical cleanser and covered with a sterile cloth, exposing only the surgical area.
- Once you are sedated by the anaesthetist, an endotracheal tube will be placed to help you breathe during the procedure. The anaesthetic will relax your muscles and make it difficult for you to breathe, and this process will allow the team to help you control your breathing while you are on the ventilator.
Once you are fully prepared for surgery, the surgical team will first collect the three blood vessels needed for the bypass. Blood vessels can be taken from your legs (saphenous vein), from inside your chest (internal mammary artery), or from your arm (radial artery).
After the surgeon harvests the blood vessels, a mid-sternal vertical incision is made in the center of the sternum to allow access to the heart. Depending on the surgeon, the patient may be placed on a bypass machine during the procedure. Surgery can be done “pump on” or “pump off”.
cardiopulmonary bypass surgery Refers to the use of a heart-lung machine to circulate blood and breath to the body throughout the procedure. This machine allows doctors to stop the beating of the heart.
The second technique used is off-pump surgery, also known as “beating heart surgery.” It is done while the heart is still beating, without the use of a heart-lung machine. It is a more difficult procedure to perform due to its technical precision, but it is the method of choice for some surgeons.
According to the National Institute for Health and Care Excellence (NICE), the procedure is as effective as coronary artery bypass grafting with a pump. This is a newer technology that has shown some added benefits, including:
- faster than traditional programs
- Reduce the chance of bleeding during surgery
- Reduce the risk of certain serious complications after surgery, such as stroke
- Shorten hospital stay
After implantation of the graft, the heart is restarted (if needed) with controlled electrical shocks. The surgical incision is closed with mesh tape, sutures, and/or staples according to the surgeon’s preference.
Steps of heart bypass surgery
Immediately after triple bypass surgery, you will be transferred to the Intensive Care Unit (ICU) or Cardiac Intensive Care Unit (CICU or CCU) for close monitoring. You will usually be on an endotracheal breathing tube for a few hours after surgery and still be connected to a ventilator.
You will get medicine to keep you sleepy. If you start waking up, you won’t be able to talk on the snorkel. It can be uncomfortable, but it shouldn’t be painful. Once fully awake, the breathing tube will be removed.
You will spend at least one day in the intensive care unit and will be hooked up to a variety of machines, including vital signs monitors, IV pumps to deliver fluids and medications, and catheters to empty your bladder.
After your initial ICU recovery, you will be transferred to the telemetry medical operating room to continue your recovery. At this point, you will meet with a physical therapist, occupational therapist, and nutritionist to continue the recovery process.
After surgery, everything will be more difficult, including eating, dressing, bathing and other activities of daily living. This is normal and to be expected after triple bypass surgery. Working with your medical team will help you start feeling more normal.
Triple Bypass Surgery: Recovery
It is important to follow all instructions from your medical team before, after, and during triple bypass surgery. Although the most common type of open-heart surgery, this procedure is serious and can have life-threatening complications.
Discuss any concerns and questions with your surgeon before surgery to fully understand the procedure and recovery process.