Double Bypass Surgery

Why You Might Need Double Bypass Surgery

A double heart bypass operation is used to treat coronary artery disease. This type of heart disease occurs when the arteries that supply blood to the heart muscle become narrowed or blocked due to a buildup of fatty deposits, known as plaque.

When these arteries become too narrow, your heart muscle may not receive enough blood with oxygen. This lack of oxygen in the blood supply is particularly prevalent during exercise or periods of stress.

You may experience heart disease symptoms such as:

• Chest pain (angina)
• Shortness of breath
• Fatigue

In more severe cases of coronary heart disease, a complete blockage can cause a heart attack.

Possible Complications & Risks of Double Coronary Bypass Surgery

While double coronary artery bypass surgery is a standard procedure, like all major surgeries, it carries risks. Some are procedural, while others depend on individual patient factors.

General Risks

• Stroke: Occurs in approximately 1% of patients during or shortly after surgery.
• Mortality: Risk varies based on age, medical history, and overall health status.
• Advanced age: Older patients face an elevated risk of stroke, complications, and prolonged recovery.

Patient-Specific Risk Factors

Certain pre-existing conditions increase surgical risk:

• Frailty (reduced physical strength and functional capacity)
• Poorly controlled diabetes mellitus
• Chronic obstructive pulmonary disease (COPD)
• Co-existing illnesses such as liver disease
• Peripheral arterial disease (PAD)
• Previous heart attack with permanent heart muscle scarring

Common Postoperative Complications

• Pleural effusion: Fluid build-up in the chest cavity affects approximately 11% of patients and may extend hospitalisation.
• Extended surgery time: Prolonged use of the heart-lung machine and aortic cross-clamping increases the risk of complications.
• Low body mass: Associated with a higher risk of pleural effusion and other complications.
• Progressive angina: Chest pain that recurs or persists after surgery, not to be confused with postoperative pain
• Deep sternal wound infection: More common with traditional open heart surgery than minimally invasive approaches.
• Vein graft failure (VGF): VGF is common and increases the likelihood of needing another procedure, but does not typically raise the risk of heart attack or death.

Individual Risk Assessment

Each patient presents a unique risk profile. At the Keyhole Heart Clinic, we do comprehensive preoperative assessments and diagnostic imaging to determine the best treatment plan for each individual.

Selecting an experienced surgical team that can personalise a treatment plan for your needs is vital for optimising outcomes and facilitating optimal recovery.

UK First in Keyhole Heart Bypass Surgery

Mr Inder Birdi, Director of the Keyhole Heart Clinic, has rare expertise as one of only a handful of surgeons capable of performing keyhole coronary bypass surgery.

He achieved a medical milestone in 2022 when he completed the UK’s first quadruple heart bypass using the Total Coronary Revascularisation via Anterior Thoracotomy (TCRAT) technique.

Watch the patient tell his story in his own words.

Benefits of a Keyhole Double Bypass Surgery Procedure

As TCRAT allows for multi-vessel bypass surgery, patients can expect similar recovery benefits to those seen with MIDCAB procedures, such as:

• Faster recovery and earlier hospital discharge
• Less pain
• Reduced risk of excessive bleeding
• Reduced risk of infection
• No risk of bone infection, since the breastbone isn’t opened
• Better cosmetic results
• Return to regular activity, such as golf, tennis, or light gym exercise, within 3 to 4 weeks

Advanced Double Bypass Technique

At The Keyhole Heart Clinic, we’ve helped develop and refine Total Coronary Revascularisation via Anterior Thoracotomy (TCRAT). This advanced technique enables our team to perform multi-vessel bypass surgery through a small keyhole incision.

Features of TCRAT:

• Performed through a 5-8 cm incision on the left side of the chest, between the ribs
• Provides access to all major coronary arteries
• No need to split the breastbone (sternum), resulting in reduced trauma and faster recovery
• Utilises specialised instruments and video-assisted technology for exceptional precision

Suitability for TCRAT

TCRAT is typically suitable for patients who:

1. Have multi-vessel coronary artery disease
2. Are clinically stable
3. Have a favourable anatomy that allows access through a small incision

Your surgeon will confirm suitability using angiograms and CT imaging before recommending this procedure.

After Your Surgery

The process is handled with the utmost care. You will be transferred to the Intensive Care Unit (ICU) for close monitoring during early recovery. An experienced healthcare team will support you as you begin to recover.

Cardiac rehabilitation will be an essential part of your recovery, helping you return to an active and healthy lifestyle with improved heart function.