Heart bypass surgery explained. Heart surgeon Dr. Andre Wessels explains the procedure of bypassing blood around clogged arteries to improve blood flow and oxygen to the heart. See more at: http://gulfnews.com/gntv
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00:00The patient was a 55-year-old patient who presented with a heart attack in Libya. They
00:19diagnosed that he had a heart attack, which means that one of the arteries that supply
00:23the heart muscle with blood developed a sudden blockage, and that area of heart muscle supplied
00:30by that particular blocked artery died off. In addition to that, he also had another problem
00:36where his mitral valve was leaking. He was advised not to have treatment in Libya and
00:43came to us at City Hospital in Dubai. The operation had two parts to it. The first part
00:49of the operation was to bypass the blocked coronary arteries. We found that in addition
00:55to the one that had blocked off completely causing the heart attack, there were two arteries
01:01that had significant narrowings in and had to be bypassed. That was the first part of
01:06the operation. The second part of the operation was to repair or replace the heart valve.
01:15We then open the chest down the midline, we saw through the breastbone, and we then connect
01:21the patient onto what we call a heart-lung machine. The heart-lung machine takes over
01:27the function of the heart and also the lungs. We can then stop the heart, inject a solution
01:35into the heart, which will keep it protected, and we can then do the operation. Technically
01:43one cannot excise that narrowing and join the artery together again, so a better option
01:48is to bypass that narrowing. So we use vein out of the leg for the bypass, and sometimes
01:56we also use an artery on the inside of the chest wall. That's the purpose of taking the
02:01vein out of the leg. You can understand that his circulation has now been taken over by
02:05a machine, his heart has been stopped, and the organs need to be protected, especially
02:11the brain and the heart itself. So as part of the protection we cool the patient down,
02:16as I said, to 32 degrees centigrade, and then to add extra cooling to the heart we sometimes
02:22add cold saline solution to also cool the heart, and in so doing you decrease the metabolism
02:30of the heart and you protect the heart. When you take the cross clamp off, then the blood
02:36from the patient is going into the heart again and supplying the heart muscle. Now your heart
02:42muscle has been supplied with blood, and this washes out the cardiac bleacher and then the
02:47heart will start beating. If it doesn't beat regularly, sometimes we need to give it a
02:51small electric shock, but this is how it works. We use swabs during the operation, and sometimes
03:00swabs are left in the chest. It's absolutely vitally important that all those swabs are
03:06removed before you close the chest, and that's why the counting procedure is so strict. The
03:12incidence of heart disease, specifically coronary artery disease, we find it in the younger
03:17patient group, and the reason for this is due to bad eating habits, lack of diet, lack
03:23of exercise, sedentary type of occupation, smoking, both cigarette smoking, shisha smoking.
03:30The patient is actually doing very well. We'll keep him here another 10 days and then let
03:35him go back to Indonesia to continue with his recuperation, which will take another
03:40four to six weeks, and then he goes back to work in Libya.