How long are you sick after a bypass surgery?
The duration of sick leave after a bypass operation is at least 6 weeks. This is the time that affected persons spend in hospital and then in a rehabilitation facility. Ideally, the ability to work is restored, especially during the stay in the rehabilitation clinic.
However, people with physically demanding jobs are usually on sick leave for a longer period of time. After a bypass operation, the body must first be trained again until it can reliably carry out the corresponding stresses of everyday working life. If heavy physical work is necessary in an occupational field, retraining to a less stressful occupation may also be necessary.
Is bypass surgery without a heart-lung machine also possible?
Bypass operations without a heart–lung machine are among the most technically demanding heart operations. The heart–lung machine is intended to take over the pumping function of the heart while the heart is immobilised with medication. In this way, a quiet operating field can be guaranteed for the heart.
In minimally invasive procedures, the heart-lung machine is often not used. In this case the bypasses must be inserted at the beating heart. The bypass is first attached to the affected coronary vessel. Then the aorta is partially disconnected and sewn into the disconnected area of the bypass.
The alternative: Stent
The alternative to bypass surgery is stent implantation. Nowadays, this treatment method has become widely accepted and is performed several times a day in all cardiac catheter laboratories. A stent is a thin wire frame in the form of a cylinder, which is initially in a folded state.
If a coronary artery stenosis is suspected, a cardiac catheter examination is performed. This procedure, also known as coronary angiography, is started via the patient’s inguinal artery. A thin wire is inserted over the patient’s arterial vascular system to just before the heart.
Contrast medium is then injected into the vascular system of the heart. Free areas are light in colour, constrictions are left out and dark. If the vessel is only narrowed and not closed, the folded stent can be pushed over the wire into the narrowed vessel of the heart.
Once it is positioned in the constricted area, it is unfolded and thus expands the constricted vessel. Several stents can also be inserted into the vascular system in one session. A distinction is made between stents that carry a drug film and those that are uncoated.
Coated stents usually carry anticoagulant drugs, so that a renewed formation of clots in the vessel is counteracted. The procedure takes about 30 to 60 minutes and is the standard treatment for a heart attack. Stent implantation is a relatively low-risk procedure that is performed several thousand times a day in Germany.
However, like any other procedure, it carries a statistical risk. Due to the advancement of the catheter in the arterial section of the body, small blood clots may form in the area of the entry point or in the area of the catheter. These blood clots can also be pushed forward through the catheter towards the heart and can thus lead to a complete blockage of a blood vessel, which can trigger an acute heart attack.
The procedure can also cause blood clots to spread throughout the body and lead to a stroke in the brain, for example. Furthermore, cardiac arrhythmia can occur during the procedure, which can sometimes be life-threatening. It may then become necessary to carry out appropriate resuscitation measures.
The patient is monitored on a monitor during the procedure, so that it is possible to react very quickly. Mild cardiac arrhythmias occur relatively frequently and are easily controlled. More serious and/or life-threatening rhythm disturbances occur less frequently.
In the worst case, cardiac arrest during the procedure can occur. After the implantation of a stent, patients have a good prognosis. The greatest danger is the closure of the stent due to blood clots or renewed vascular deposits.
The continuous improvement of the materials used has significantly reduced this risk. A risk of 1-2% must be assumed that a site of the arterial vessel widened by a stent narrows again within 4 years (so-called “restenosis”). This risk was higher with stent materials used earlier and could be 5-7%.
Important and decisive is of course the correct intake of an appropriate vital drug combination, which usually consists of at least 2 anticoagulants. Furthermore, a cholesterol-lowering drug should be taken and attention should be paid to a precise blood pressure reduction. The laying of a stent leads to the same complaints as a vascular constriction, namely a feeling of pressure on the chest at rest or under stress, pain, shortness of breath and irregular pulse. Patients who have had a stent implanted should pay close attention to such symptoms, take preventive medication continuously and reliably and have regular check-ups with their cardiologist.
