How Wounds Heal After Heart Operation?

Heart Surgery

Body has a natural reparative process for healing wounds. Generally wounds take about 6-8 weeks to heal completely. Bones may take a little longer. The new tissues will need some time to get used to the stress and strain of activities of daily life. This process is called the remodeling. It is natural to experience some discomfort during healing and remodeling stages.

How Are These Wounds Stitched And Are There Any Stitches To Be Removed? 

The surgical wounds are stitched using special needles and suturing threads. Some materials are biodegradable or self absorbing. They need not be removed. Some need to be removed after the necessary period (like silk and nylon).

Generally all the wounds of heart operation are repaired using self absorbing stitch materials. These can not be seen outside and need not be removed. Small wounds are sometimes repaired using silk or nylon sutures. These are usually removed just before discharge.

What To Expect After Heart Operation During First Few Weeks?

After Heart Operation

Tiredness: This is quite common after a major operation. The body is busy doing the repairing process of the wound. Heart is getting accustomed to the changed scenario. Allow adequate rest for the body and mind. Engage yourself in light recreations like reading and listening to music. Take a short (half an hour) afternoon nap. Watching TV excessively is not good as eye strain may cause exhaustion. As the days progress, you will feel better.

Reduced Appetite: There are several reasons for loss of appetite. Distaste caused by some of the medications (especially antibiotics and painkillers) is a common problem. Acidity caused by stress and some medicines is another reason. Pain and discomfort from the wounds can at times be disturbing.

Pain: is the commonest problem. We are all aware of the bad effects of some of the pain medicines like acidity and kidney problems. This apprehension prevents many patients and relatives of patients from using adequate pain relief. Remember there are safe painkillers which may be used regularly until pain in relieved fully. It is important to take regular pain medications in the first two weeks – at least one in the morning and one at bedtime.

Sleeplessness: Anxiety and pain are the villains. In the first few weeks you require adequate pain relief. Along with this, many patients need a mild anxiety relieving medicine to help them to get comfortable sleep. The medicines prescribed by our team are mild and the addiction potential is very low. So do not be afraid to take these for a short period. As the health improves, your normal sleep habit will return.

Swelling Of Legs: Mild or even moderate swelling of feet and legs are common after veins have been removed during CABG. This is because the venous blood return is affected. This is not a disease. The deep vein system will take care of the blood circulation adequately. It takes some time for the body to make this adjustment. The Swelling is usually absent or minimal in the morning when you get up. It gradually increases over the day as ‘gravity’ acts. Simple methods like leg elevation and crepe bandages or elastic stocking can relieve this problem. However, if there is redness, severe pain or discharge in the wounds, you must contact your doctor.

Sore Throat: The plastic tube which is kept in the windpipe during anesthesia and immediate postoperative period can cause mild inflammation and pain in throat during first few days. Mild pain killers and warm saline gargles can take care of this.

Numbness: One of the most common and consistent complaints after bypass operation is the pain and numbness in the left side of chest. Fine nerves along the Internal Mammary Artery (IMA) are cut while harvesting this artery for bypass. These are nerves that supply the front of chest. There may be numbness, burning pain, different feeling during touch or shooting pain. Usually Left IMA is taken. So the symptoms are on the left side of chest (may involve breast in women). If both IMA are used these symptoms can occur on both sides. The symptoms gradually resolve. In some cases it may persist for up to one year. On the same count similar symptoms may appear in the leg along the vein harvesting wound.

Is OPCAB (Off-Pump Coronary Artery Bypass) Worth The Pain And Effort?

OPCAB - Off-Pump Coronary Artery Bypass

Isn’t it interesting to know that the first ever successful bypass was done as a beating heart operation? This was way back in 1964 by a Russian surgeon, Colosev. But since then the conventional bypass operation has developed as a safe procedure and has stood the test of time.

Interest in OPCAB (Off-Pump Coronary Artery Bypass) was rekindled in the late 80s and 90s. Due to the steep learning curve and lack of evidence for better outcome compared to standard operation, many surgeons lost initial enthusiasm and went back to the old time tested methods. The few who persisted – many of them in India- have provided valuable information regarding the safety and efficacy of this demanding surgery.

From the emerging data across the world it is now clear that OPCAB can be as complete a bypass operation as the standard one. It provides better results in terms of early deaths, strokes and kidney failures. The difference becomes far more apparent in high risk patients especially very old and those having diminished kidney or lung functions. One of the most important areas where OPCAB is making its mark is the field of repeat operations. OPCAB reduces the blood loss and recovery time in those situations.

In short, OPCAB in experienced hands is as complete and more safe than the standard operation. It may be ideally suited in very old and critically sick patients.

Can All Patients Needing Bypass Have OPCAB?

This is a very technical question and one need to consider many factors before reaching a decision.

Even when OPCAB (Off-Pump Coronary Artery Bypass) is planned for a certain patient the decision can be changed on the operating table depending on conditions unique to individual patients.

A heart suffering from critical shortage of blood supply, as in the case of many undergoing bypass, may not tolerate the long operation on beating heart.

The blood vessel needing bypass may be buried deep inside the heart muscle or its wall may be very thick and hard like stone.

These situations make the operation technically difficult and may necessitate the use of CPB machine. Needless to say, every patient is unique and there is no one treatment suiting all.