Yes. Dos have the same training as mds. If a do does post-graduate training in surgery and then cardiothoracic surgery, s/he can be a cardiothoracic surgeon qualified to do cardiac bypasses.
Explain. What kind of fellow?
With a surgeon. A cardiothoracic surgery "fellow" can perform a cardiac bypass with an attending cardiothoracic surgeon at an academic institution.
Surgery. Just like bypassing traffick routes it is a way to reestablish blood flow to the blocked vessel distal to the blockage\like in the pic there is internal mammary artery bypass to left anterior artery this is a lima bypass.
Two items. The cardiac bypass machine allows open and surface cardiac surgery by allowing a quiet heart. Coronary artery bypass is the operation using internal thoracic artery, saphenous veins, or other conduits to construct detours around coronary artery obstructions and usually uses the machine as well!
Rerouting of blood. A coronary artery bypass brings more blood to the heart muscle by connecting a new tube (vein or artery) past a blockage in an artery on the heart.
Depends. Could be two things. Cardiopulmonary bypass is a machine/technique that takes over the function of the heart and lungs during cardiac surgery so that the heart can be stopped temporarily so that surgery can be performed on the nonbeating heart. Or coronary bypass (CABG) is the placement of a bypass graft, by surgery, to provide blood flow around a blocked coronary artery.
Probably. What you mean is a coronary artery bypass. This is needed when there is a severe obstruction to flow through an artery that feeds the heart. A surgeon then uses blood vessels from your body to reroute blood around the blockage. If if you are actually asking about cardiopulmonary bypass, ask again, cuz that's a while 'nother thing. Hope that helped.
Early vs late. Pts early on are sore. Hurts to cough. They feel fatigued. Over time and after a few mos pts usuall feel well. They are back diving after 6 weeks. Many get enrolled in cardiac rehab. Pts actually will ultimately feel better with less angina due to the improved blood flow to the heart.
It doesn't. Robotic surgery is just a tool that allows the surgeon, who is controlling the device, to work in smaller spaces with less tissue trauma, shortening recovery and hopefully producing less discomfort.
Pretty normal. Most patients feel different during the first 48 hours but quickly adapt. By two weeks a lot feel back to normal and certainly by 8 weeks the vast majority are back to work and resuming normal activity. Try some stretching exercises and take your pain meds especially during the first two weeks.
Protect the sternum. Essentially after any procedure that involves cutting the sternum, one has to protect it for a while (up to three months in some cases). It is best to support the sternum with a pillow (we give a "heart pillow" to the patients) which is pressed against the chest when the patient is sneezing or coughing. Patient is instructed essentially to hug the pillow. No specific rest position that I know of.
Yes. Actually, by definition, people are put on a ventilator during all operations with general anesthesia. Due to the complexity of the surgery, many people are kept on the ventilator after open-heart surgery, however this is usually only for a short time. This is actually a quality metric reported by many cardiac surgery programs: see www. Sts. Org (risk adjusted prolonged intubation).
Interesting. Patients are mechanically ventilated immediately upon start of anesthesia. When on cardiopulmonary bypass, circulation to lungs and heart stops. Ventilator turned off and oxygenated through bypass pump. Ventilation resumes when done with bypass until extubated. Off-pump cabg, you stay on ventilator entire time as no bypass pump used.