In some countries, the requirements for operation are not as stringent and surgeons are operating because the disease is present and amenable to operation, even if the patient is not greatly inconvenienced.
The patient’s age, general condition and occupation are all considered before operation. Several investigations may be necessary to establish the extent of the disease and which arteries are involved and where is the narrowed portion.
These investigations include an electrocardiogram (ECG) and chest X-ray. Echograms using ultrasound may show the outlines of the heart chambers.
Stress testing, where the person is exercised and monitored with cardiographs, may indicate not only the presence of artery disease, but also its extent. The most important investigation however, is the procedure of coronary angiography.
In this, a thin flexible tube or catheter is inserted into an artery in the arm or leg and pushed along until it enters the aorta. It is then guided into the opening of the coronary arteries.
A radio-opaque dye is injected through the catheter and flows along the coronary arteries. X-rays are taken and show the arteries and whether they are narrowed or blocked.
A bypass operation is major surgery, but the benefits are certainly greater than the risks.
Coronary artery bypass surgery is no longer experimental. It has an established place in the management of coronary artery disease and can be offered to selected patients as a means of reducing the severe effects of the disease and improving their chances of returning to full and productive life. It also holds the potential of increasing the lifespan of those with established disease in their coronary arteries.
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