Cardiology. Aortocoronary bypass surgery
One of the most common and most common diseases of mankind is a heart attack. However, as practice shows, in most cases people, when there are unpleasant sensations and even pain in the chest, feeling a lack of oxygen or stiffness of breathing, do not rush to apply to specialists, preferring to be treated independently. Ignoring the first manifestations of a serious illness, they thus largely prevent further treatment and recovery. Timely contact with a doctor guarantees competent diagnosis and the appointment of a qualified treatment. It should be noted that when symptoms of cardiovascular diseases manifest themselves, timely shunting( operation to form a bypass way of the site of narrowing of the affected vessel) can save lives and return the patient to a healthy and fulfilling life.
Cardiovascular diseases are accompanied by a lesion( constriction) of one or several vessels supplying the heart muscle. Aortocoronary bypass allows to provide a healthy blood flow through an additional artery or vein. Thus, the heart muscle will receive a normal blood supply.
To access the heart, a cut is made in the center of the chest. In addition, an incision is made at the donor site from which the surgeon will take a piece of the artery for bypass surgery.
More preferred are the internal thoracic artery or the radial artery of the hand. They can provide the most complete functionality and durability of the shunt. Before using the radial artery of the hand, additional studies are carried out to prevent various complications that may be associated with its fence.
Extraction of the thoracic artery is made from under the sternum. As a rule, the left artery is used, however, the use of the right artery is also practiced. In the course of coronary angiography, there is a lack( presence) of atherosclerotic lesions and a sufficient diameter of the artery.
Surgeons also practice artery removal from the leg.
The operation of bypass surgery on the heart has three main types. In the first case, artificial blood circulation is used, in the second case, the intervention is performed without it, using the "stabilizer".The third type of surgery is performed with minimal surgical incisions( endoscopic interventions).
The choice of a particular species is possible only by coronary angiography and evaluation of the degree of arterial damage.
Aortocoronary bypass with the use of artificial circulation is the only option for combined heart pathology( postinfarction left ventricular aneurysm, acquired or congenital heart disease requiring surgical intervention) or in the case of multifocal coronary artery disease. With this surgical procedure, cardiac arrest can be performed. To provide artificial circulation, the heart muscle is connected to the cannula, which are connected to the device. At this time an anastomosis is created between the vein and the coronary artery. After this, the restoration of the heart is performed, and the aorta is sewn to the opposite end of the vein. The duration of this intervention depends on its complexity and individual characteristics of the patient.
The normal functioning of the surgical technique allows performing aortocoronary bypass with a working heart. In this case, a technique is used that reduces cardiac fluctuations during the intervention.
The use of minimum cuts during the operation has several advantages. First, the probability of infection of the patient decreases. Secondly, aortocoronary shunting through smaller incisions reduces blood loss. In addition, the patient is able to clear his throat and breathe more deeply in the postoperative period.