• 2 days ago
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
Transcript
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.

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