Questions posted in the Heart Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: 2nd surgery in 4 years

Forum: The Heart Forum
Topic: Bypass Surgery


My father had successful quadruple bypass surgery four years ago. Five weeks ago, he suffered a severe blow to the chest that triggered a heart attack two days after the accident.

Doctors tell us they will have to do more open heart surgery to repair this damage. This includes patching an aneurysm, 2-3 bypasses, and possible valve replacement.

My dad is a strong man, but he cried when told the news. Will his post-op healing process be as painful as the first? (They plan to go in from the side this time.)

Also, I am concerned about having the second operations only four years after the first. Aside from the pain, my dad experienced few problems after the first operation. Are there any greater risks with a second operation that we should be aware of?

I'm afraid to ask doctors these questions while my father is present, but I want to be an informed caretaker when he comes home. I greatly appreciate having this forum. Thank you.



Dear Karen, thank you for your question. Your father faces a major operation
in a redo bypass surgery with an aneurysm repair and valve replacement, but he
should still have a good chance of a successful outcome. Typically, bypass
grafts from the leg veins (saphenous veins) last 10-12 yrs. but some grafts become
occluded within the first 5 years. There is no specific time frame as to when
redo bypass surgeries are performed in relation to the first surgery because
each patient is different. Technically, cardiac surgeons have more difficulty
in performing a redo bypass surgery due to adhesions and scar tissue in the
chest from the first surgery. That may be why your surgeon is planning to use
a lateral approach (called a thoracotomy) to avoid scar tissue that may be present
behind the sternum. I can't really say how he will handle the post-op healing
and pain because each patient has a different pain threshold. However, it's been
my experience that patients do not have more pain after a redo bypass surgery.
A redo bypass surgery is more risky than a first bypass surgery, but only your
surgeon could quote you accurate risks. Risk assessment involves many considerations
like the patients age, coexisting medical conditions, coronary artery anatomy,
and left ventricular function (measure of how efficiently the heart can pump
blood). Overall, I think you should talk with your father's surgeon and cardiologist
on your own if you are worried about bringing these issues up around him. I
hope you find this information useful.

Information provided in the heart forum is for general purposes only. Specific
diagnoses and therapies can only be provided by your physician.




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