Second time bypass has become a very standard procedure nowadays. As many of the patients are operated in late 60’s and 70’s so the need for a second bypass surgery arises. There is no specific limit of times that a person can undergo bypass surgery. But with each surgery, the risk also goes on increasing.
Thanks to continuing advances in heart surgery and improved life expectancy, many people live long enough to require a second heart operation, commonly called a heart reoperation. An operation duplicating your first surgery is often successful, but if you’re considering this type of surgery, you need to understand its unique challenges.
What Makes a Reoperation Surgery More Challenging?
First of all, you’re older than you were when you had your initial heart surgery, and you are possibly dealing with additional medical problems. Depending on how serious your other medical issues may be, a reoperation can be more difficult to recover from.
Second, you probably have adhesions which are similar to scar tissue. These web-like connections between the structures in your chest can develop as a result of the first operation. This may present technical difficulties for your surgeon, especially if they are not experienced in performing reoperations. A preoperative CT scan can be helpful to determine the safety of and strategy for reentering your chest.
Progression of your disease
If you had coronary bypass grafting before, your surgeon likely used your best arteries for the first surgery, and now he or she must rely on a segment of artery that is further along the vascular tree.
If you had a valve operation, you may now have disease involving multiple valves. If you have aortic disease, you may have an aneurysm involving an additional segment of your aorta. Or you may now have disease involving one of these structures that did not need attention during the previous operation.
These multi-component operations are best handled by a team with experience preparing for and performing these complex operations.
Why Would You Need Heart Reoperation Surgery?
There are several reasons why you may need a second (or third, fourth or more) heart operation.
It’s been a while since your first surgery
If you had coronary artery bypass, you may find that you need a second surgery later in life because of new disease in your own vessels or disease that has developed in your bypass grafts. How long a coronary artery bypass lasts depends on a number of things, including:
. Type of bypass used (vein or artery)
. Quality of the coronary arteries being bypassed
. Risk factors (such as smoking, extra weight, high cholesterol, lack of exercise)
. Genetic tendencies
A valve repair or replacement fails
If you had a heart valve repair or replacement, the operation sometimes needs to be repeated. Repairs are typically chosen over replacement because of the prospect for longer durability.
Depending on the reason for the first repair, sometimes the valve itself will still degenerate over time. Similarly, tissue replacement valves are known to wear out over time (usually in the second decade) and even mechanical valves can develop later problems that may require a reoperation.
For example, the valve might start to leak or allow blood to flow backwards (regurgitate). This impairs your heart function. We can often repair the valve again to achieve the outcomes that we hoped for in the first surgery, or we can replace (or re-replace) the valve.
If you develop an infection or other complications from your initial surgery, you may need a second heart surgery. These reoperations are particularly difficult and should be addressed by a team familiar with the safest techniques for successful treatment.
What You Need to Know Before Scheduling Surgery?
Here are a couple of key suggestions if your doctor says you need a heart reoperation:
. Choose an experienced surgeon. Find someone who has done many heart reoperations. This type of procedure is not as common as an initial heart surgery, so it may take you more time to find the best-qualified physician.
. Hospital experience matters, too. Choose a hospital that has a lot of experience with reoperations and has a team of physicians readily available to handle any other medical issues you have.
Patients who have high risk factors or who undergo second procedures do best at high-volume medical centers where the surgical and support teams have a lot of experience. Almost one-third of the heart surgery operations we do are repeat procedures.
If you’re facing a heart reoperation, keep in mind that the safety and success of these surgeries continue to grow, particularly when an experienced surgeon does your surgery at a high-volume center. Take the time to choose your hospital and surgeon carefully for the best outcome.
About Iranian Surgery
Iranian surgery is an online medical tourism platform where you can find the best cardiac specialists and surgeons in Iran. The price of Open-Hear Surgery in Iran can vary according to each individual’s case and will be determined by an in-person assessment with the doctor.
For more information about the cost of Open-Hear Surgery in Iran and to schedule an appointment in advance, you can contact Iranian Surgery consultants via WhatsApp number 0098 901 929 0946. This service is completely free.