Life expectancy after coronary artery bypass surgery. After coronary artery bypass surgery

Coronary artery bypass grafting is one of the “popular” operations that is used to treat coronary heart disease, incl. and myocardial infarction.

The essence of this operation is to create a bypass path - a shunt - for the blood that feeds the heart. That is, the blood along the newly created path bypasses the narrowed or completely closed section of the coronary artery.

To perform coronary artery bypass grafting, either the saphenous vein is taken from the leg (provided there is no venous pathology in the patient), or an artery is taken, usually the thoracic artery.

Coronary artery bypass surgery is performed under general anesthesia. The operation is open, that is, a classic incision is made to access the heart. The surgeon uses angiography to identify a narrowed or blocked area of ​​the coronary artery by plaque, and stitches a shunt above and below this place. As a result, blood flow in the heart muscle is restored.

In some cases, the operation can be performed, as indicated above, on a beating heart, without the use of a heart-lung machine. The advantages of this method are:

The operation lasts on average about 3 – 4 hours. After the operation, the patient is transferred to the intensive care unit, where he remains until consciousness is restored - on average one day. After which he is transferred to a regular ward of the cardiac surgery department.

Rehabilitation after coronary artery bypass surgery

Rehabilitation after coronary artery bypass surgery is basically the same as for other heart diseases. The goal of rehabilitation in this case is to restore the performance of the heart and the whole body, as well as to prevent new episodes of coronary artery disease.

So, the main thing in rehabilitation after coronary artery bypass surgery is measured physical activity. It is carried out with the help of individually selected physical exercise programs, with or without the help of simulators.

The main types of physical exercise are walking, health path, light running, various exercise machines, swimming, etc. All these types of physical activity in one way or another put stress on both the heart muscle and the entire body. If you remember, the heart is mostly a muscle, which, of course, can be trained in the same way as other muscles. But the training here is unique. Patients who have had heart disease should not exercise as much as healthy people or athletes.

During all physical exercises, mandatory monitoring of important parameters of the cardiovascular system, such as heart rate, blood pressure, and ECG data is carried out.

Physical therapy is the basis of cardiac rehabilitation. It is also worth noting the fact that physical activity helps relieve emotional stress and fight depression and stress. After therapeutic exercises, as a rule, anxiety and restlessness disappear. And with regular exercises, insomnia and irritability disappear. And, as you know, the emotional component in IHD is an equally important factor. After all, according to experts, one of the reasons for the development of diseases of the cardiovascular system is neuro-emotional overload. And therapeutic exercises will help to cope with them.

In addition to physical exercise, psychotherapy also plays an important role. Our specialists will help you cope with stress and depression. And, as you know, these two phenomena can directly affect the condition of the heart. For this purpose, our sanatorium has excellent psychologists who will work with you either individually or in a group. Psychological rehabilitation is also an important part of the entire cardiac rehabilitation.

It is also very important to control your blood pressure. It should not be allowed to increase due to physical activity. Therefore, you need to constantly monitor it and take the necessary medications prescribed by your doctor.

Depending on the condition of the body, in addition to therapeutic exercises and walking, other types of physical activity can be used, for example, running, vigorous walking, cycling or exercise on an exercise bike, swimming, dancing, skating or skiing. But such types of exercise as tennis, volleyball, basketball, training on exercise machines are not suitable for the treatment and prevention of cardiovascular diseases; on the contrary, they are contraindicated, since long-term static loads cause increased blood pressure and heart pain.

For rehabilitation after coronary artery bypass surgery, methods such as aromatherapy and herbal medicine are also used.

Another important aspect of rehabilitation is teaching the correct lifestyle. If after our sanatorium you give up physical therapy and continue to lead a sedentary lifestyle, then it is hardly possible to guarantee that the disease will not worsen or worsen. Remember, a lot does not depend on pills!

It seems to us that the correct development of a diet is very important. After all, it is from cholesterol, which enters your body with food, that atheromatous plaques are formed, narrowing the blood vessel. And a shunt after surgery is the same vessel as the coronary arteries, and it is also susceptible to the formation of plaques on its wall. That is why it is so important to understand that the whole matter does not end with just one operation, and proper rehabilitation is important.

You probably already know what is important in the diet of a patient with heart disease - eat less fat, table salt, and more fresh vegetables and fruits, herbs and grains, as well as vegetable oils.

Our specialists will also have a conversation with you aimed at helping you get rid of bad habits, especially smoking, which is one of the important risk factors for IHD.

Cardiac rehabilitation also involves eliminating all, if possible, risk factors for coronary artery disease. This is not only smoking, but also alcohol, fatty foods, obesity, diabetes, hypertension, etc.

Rehabilitation after CABG

Rehabilitation after CABG, as after any other abdominal surgery, is aimed at the speedy recovery of the patient’s body. Recovery after CABG surgery begins with the removal of sutures, including sutures from the areas from which veins were taken for bypass surgery (usually the saphenous veins of the legs). Immediately after surgery, from the first day and for five to six weeks (before and after removal of sutures), patients must wear special support stockings. Their task is to help restore blood circulation in the legs and maintain body temperature. Since after the operation the blood flow is distributed through the small veins of the leg, temporary swelling and swelling may be observed, which disappear within the first month and a half.

Recovery after CABG

As the main means for the recovery of patients after CABG, physical activity is used from the first day after surgery. On the first day you can already sit up in bed, reach for a chair, making several attempts. On the second day, you can already get out of bed and, with the help of a nurse, move around the ward, and also begin performing simple physical therapy exercises for your arms and legs.

After the suture on the sternum has healed, the patient is allowed to move on to more complex exercises (usually after five to six weeks). The main recommendation is dosing physical activity and limiting weight lifting. The main types of exercise during this period include walking, light running, various exercise equipment, and swimming. During physical exercise, starting from the first day after surgery and as the patient recovers, the most important indicators of the cardiovascular system are monitored - blood pressure, pulse rate, ECG.

The rehabilitation program is prescribed by a specialist in rehabilitation therapy - a cardiologist. In the conditions of city hospital No. 40, it is carried out on the basis of the department of medical rehabilitation of patients with somatic diseases, located on the 3rd floor of the hospital’s therapeutic building.

Rehabilitation of coronary artery bypass surgery

Myocardial infarction is one of the most common diseases not only in the elderly, but also in middle age. The mortality rate for this disease is quite high, almost 50%.

Cause

The main cause of occurrence is cardiac ischemia, which develops due to narrowing or complete blockage of the coronary vessels, those that feed the heart. The heart, although it is an organ that passes large volumes (flows) of blood through itself, receives nutrition not from the inside, but from the outside, through the system of coronary vessels. And of course, if they are amazed, then this is immediately reflected in his work.

Coronary artery bypass surgery

At an advanced stage of coronary heart disease, when the risk of myocardial infarction is significant, coronary artery bypass surgery is resorted to. Using part of the saphenous vein of the lower limb or the thoracic artery, an additional path for blood is created, bypassing the coronary vessel affected by atherosclerosis.

They operate on an open heart, with an opening of the sternum, therefore, after discharge from the hospital, rehabilitation measures are aimed not only at restoring heart function and preventing repeated episodes of ischemia, but also at speedy healing of the sternum. To do this, heavy physical exertion is excluded, and patients are warned not to drive, due to the risk of injury to the sternum.

Rehabilitation

In addition, if a vein of the lower limb was used for the operation, then due to swelling that persists for some time, there are a number of restorative measures for it: wearing elastic stockings and keeping the leg elevated in a sitting position.

Many patients, after undergoing surgery, are overly protective of themselves and move less, which in no case should be done. The heart is a muscle, and therefore it must be constantly trained. Physical activity is necessary, but it must be gentle and dosed.

Walking, running, swimming, exercise bikes are suitable. However, not all sports should be preferred. For example, team sports that involve long-term static loads, such as volleyball, basketball, tennis, are contraindicated. They contribute to an increase in blood pressure, and this should not be allowed, because... unwanted stress on the heart increases.

Blood pressure monitoring should be mandatory, especially after exercise.

In addition to strengthening the heart muscle and the body as a whole, physical exercise allows you to relieve emotional stress, which is one of the factors in the development of coronary artery disease.

Diet for coronary artery bypass surgery

During rehabilitation after coronary artery bypass surgery, adherence to diet is not unimportant. It is necessary to exclude fatty and salty foods, and include more greens, vegetables, and fruits in your diet. You should radically change your lifestyle by giving up bad habits: smoking, drinking alcohol, overeating.

Only in combination with physical exercise, proper nutrition and healthy lifestyle, can the risk of re-developing coronary artery disease be reduced to zero.

It is worth getting another doctor's opinion on recovery after heart bypass surgery.

Life after coronary artery bypass surgery. Physical activity, nutrition

In February of this year, I came across the article “Shunts do not last forever.” A correspondent for the Evening Moscow newspaper talked with the head of the laboratory of X-ray endovascular methods of the Cardiology Research Center, Doctor of Medical Sciences A.N. Samko. The discussion was about the effectiveness of coronary artery bypass grafting (CABG) operations. Dr. Samko painted a bleak picture: after a year, 20% of shunts close, and after 10 years, as a rule, all of them! In his opinion, repeat bypass surgery is risky and extremely difficult. This means that life is guaranteed to be extended by only 10 years.

My experience as a long-time cardiac surgical patient who has undergone two coronary artery bypass operations suggests that these periods can be increased, primarily through regular physical activity.

I view my illness and operations as a challenge from fate that must be actively and courageously resisted. Unfortunately, physical activity after CABG is mentioned only in passing, by the way. Moreover, there is an opinion that some patients after heart surgery live safely and for a long time without making any effort. I have never met such people. What I want to talk about is not a miracle, not luck or a fortunate coincidence, but a combination of the high professionalism of the doctors of the Russian Scientific Center for Surgery and my perseverance in implementing my own program of restrictions and loads (RON).

My story is this. Born in 1935. In his youth he suffered from malaria for many years, and during the war from typhus. Mother - a heart patient, died at 64 years old.

In October 1993, I suffered an extensive transmural posterolateral myocardial infarction of the left ventricle, and in March 1995 I underwent coronary artery bypass grafting - 4 shunts were sewn in. Thirteen years later, in April 2008, angioplasty of one shunt was performed. The other three were functioning normally. And after 14 years and 3 months, I suddenly started having angina attacks, which I had never had before. I went to the hospital, then to the Scientific Cardiology Center. I underwent further examination at the Russian Scientific Center for Surgery. The results showed that only two of the four shunts were functioning normally, and on September 15, 2009, Professor B.V. Shabalkin performed a repeat coronary artery bypass surgery on me.

As you can see, I have been able to significantly extend the average life expectancy with shunts, and I am convinced that I owe this to my RON program.

Doctors still consider my post-operative physical activity too high and advise me to rest more and take medication constantly. I can't agree with this. I want to make a reservation right away - there is a risk, but it is a justified risk. Understanding the seriousness of my situation, from the very beginning I introduced certain restrictions into my system: I excluded jogging, exercises with dumbbells, on the horizontal bar, hand push-ups and other strength exercises.

Typically, clinic doctors classify CABG surgery as an aggravating factor and believe that the person undergoing surgery has only one destiny: to live out his life quietly and calmly and constantly take medications. But bypass surgery ensures normal blood supply to the heart and the body as a whole! And how much work has been invested, effort and money spent to save the patient from death and give him the opportunity to live on!

I am convinced that even after such a difficult operation, life can be fulfilling. And I can’t come to terms with the categorical statements of some doctors that my workload is excessive. They are feasible for me. But I know that if atrial fibrillation appears, severe pain in the heart area, or the lower limit of blood pressure exceeds 110 mm Hg, you must immediately call an ambulance doctor. Unfortunately, no one is immune from this.

My RON program includes five points:

1. Physical training, constant and gradually increasing to a certain limit.

2. Dietary restrictions (mainly anti-cholesterol).

3. Gradually reduce your medications until you stop taking them completely (I only take them in emergencies).

4. Prevention of stressful conditions.

5. Constantly being busy with interesting things, leaving no free time.

Gaining experience, I gradually increased physical activity, included new exercises, but at the same time strictly controlled my condition: blood pressure, heart rate, did an orthostatic test, a test for heart fitness.

My daily physical activity consisted of measured walking (3-3.5 hours at a pace of steps per minute) and gymnastics (2.5 hours, 145 exercises, 5000 movements). This load (metered walking and gymnastics) was performed in two doses - in the morning and in the afternoon.

Seasonal loads were added to the daily loads: skiing with stops every 2.5 km to measure heart rate (total 21 km in 2 hours 15 minutes at a speed of 9.5 km per hour) and swimming, one-time or fractional - pom (800 m in 30 minutes).

In the 15 years since my first CABG operation, I have walked 80 thousand kilometers, covering a distance equal in length to two equators of the earth. And until June 2009, I didn’t know what angina attacks or shortness of breath were.

I did this not out of a desire to demonstrate my exclusivity, but because of the conviction that blood vessels, natural and artificial (shunts), fail (clog) not from physical exertion, especially strenuous ones, but due to progressive atherosclerosis. Physical activity inhibits the development of atherosclerosis, improves lipid metabolism, increasing the content of high-density cholesterol (good) in the blood and reducing the content of low-density cholesterol (bad) - thereby reducing the risk of blood clots. This is very important for me, since my total cholesterol levels fluctuate at the upper limit. The only thing that helps is that the ratio of high and low density cholesterol, the content of triglycerides and the cholesterol coefficient of atherogenicity never exceed the established standards.

Physical exercises, gradually increasing and giving an aerobic effect, strengthen muscles, help maintain joint mobility, increase minute blood output, reduce body weight, have a beneficial effect on intestinal function, improve sleep, increase tone and mood. In addition, they help in the prevention and treatment of other age-related diseases - prostatitis, hemorrhoids. A reliable indicator that the load is not excessive is nasal breathing, so I breathe only through my nose.

Everyone is sufficiently informed about measured walking. But I would still like to cite the opinion of a famous surgeon, who himself was not involved in sports, but was fond of hunting, to confirm its usefulness and effectiveness. And hunting means walking for many hours. We will talk about Academician A.V. Vishnevsky. Since his student years, fascinated by anatomy and having perfectly mastered the art of dissecting, he loved to tell his acquaintances all sorts of interesting details. For example, there are 25 joints in each human limb. With each step, 50 articulated sections are thus set in motion. The 48 joints of the sternum and ribs and the 46 bony surfaces of the spinal column do not remain at rest. Their movements are barely noticeable, but they are repeated with every step, with every inhalation and exhalation. Considering that there are 230 joints in the human body, how much lubricant do they need and where does this lubricant come from? Having asked this question, Vishnevsky answered it himself. It turns out that the lubricant is supplied by a pearly-white cartilaginous plate that protects the bones from friction. There is not a single blood vessel in it, and yet the cartilage receives nutrition from the blood. In its three layers there is an army of “builder” cells. The upper layer, which wears out due to friction of the joints, is replaced by the lower ones. This is similar to what happens in the skin: with each movement, the clothing erases dead cells from the surface layer, and they are replaced by underlying ones. But the cartilage-former does not die ingloriously, like a skin cell. Death transforms him. It becomes soft and slippery, turning into a lubricant. This way, a uniform layer of “ointment” is formed on the rubbing surface. The more intense the load, the more “builders” die and the faster the lubricant is formed. Isn't this a walking hymn!

After the first CABG operation, my weight remained within kg (with a height of 165 cm), I took medications only in emergency cases: with increased blood pressure, temperature, heart rate, headaches, and arrhythmia. The main difficulty for me was my easily excitable nervous system, which I practically could not cope with, and this affected the results of the examinations. A sharp increase in blood pressure and heart rate due to anxiety misled doctors about my actual physical capabilities.

After analyzing statistical data from long-term physical training, I determined the optimal heart rate for my operated heart, guaranteeing the safety and aerobic effect of physical exercise. My optimal heart rate is not unambiguous, like Cooper’s; it has a wider aerobic range of values, depending on the type of physical activity. For gymnastic exercises - 94 beats/min; for measured walking - 108 beats/min; for swimming and skiing - 126 beats/min. I rarely reached the upper limits of my heart rate. The main criterion was that the restoration of the pulse to its original value was, as a rule, rapid. I want to warn you: the optimal pulse recommended by Cooper for a 70-year-old man - 136 beats / min - after myocardial infarction and CABG surgery is unacceptable and dangerous! The results of long-term physical training confirmed every year that I was on the right path, and the conclusions made after the first CABG operation were correct.

Their essence is as follows:

The main thing for the operator is a deeply conscious understanding of the significance of the CABG operation, which saves the patient by restoring normal blood supply to the heart muscle and gives him a chance for the future, but does not eliminate the cause of the disease - vascular atherosclerosis;

The operated heart (CABG) has great potential, which manifests itself with a properly selected lifestyle and physical training, which should be done constantly;

The heart, like any machine, needs to be trained, especially after a myocardial infarction, when more than 25% of the heart muscle has turned into scar, and the need for normal blood supply remains the same.

Only thanks to my lifestyle and physical training system I managed to maintain good physical shape and undergo repeat CABG surgery. Therefore, in any conditions, even in the hospital, I always tried not to stop physical training, albeit in a reduced volume (gymnastics - minutes, walking around the ward and corridors). While in the hospital, and then in the Cardiology Research Center and the Russian Research Center for Surgery, I walked a total of 490 km before the repeat CABG operation.

Two of my four shunts, installed in March 1985, survived for 14.5 years with the help of physical training. This is a lot compared to the data in the article “Shunts are not forever” (10 years) and the statistics of the Russian Scientific Center for Surgery (7-10 years). So the effectiveness of controlled physical activity for myocardial infarction and coronary artery bypass surgery seems to me to be proven. Age is not a barrier. The need and volume of physical activity should be determined by the general condition of the operated patient and the presence of other diseases that limit his physical activity. The approach must be strictly individual. I was very lucky in that I always had an intelligent, sensitive and attentive doctor next to me - my wife. She not only observed me, but also helped me overcome both medical illiteracy and fear of a possible negative reaction of the cardiovascular system to constantly increasing physical activity.

Experts say that repeat operations pose a particular challenge for surgeons around the world. After my second operation, my rehabilitation did not proceed as smoothly as the first time. Two months later, some signs of angina appeared with this type of exercise, such as measured walking. And although they were easily removed by taking one tablet of nitroglycerin, this really puzzled me. Did I understand? that it is impossible to draw hasty conclusions - too little time has passed since the operation. And rehabilitation began in the sanatorium already on the 16th day (after the first operation, I began more or less active actions 2.5 months later). In addition, it was impossible not to take into account that I had become 15 years older! All this is true, but if a person, thanks to his system, achieves certain positive results, he is inspired and confident. And when fate throws him back overnight, making him vulnerable and helpless, this is a tragedy associated with very strong emotions.

Having pulled myself together, I began to work out a new program of life and physical training and quickly became convinced that my work was not in vain, since the main approaches remained the same, but the volume and intensity of the loads would have to be increased more slowly, taking into account my new condition and in conditions of strict control over it. Starting with slow walks and 5-10-minute gymnastic warm-ups (head massage, rotational movements of the pelvis and head, inflating the ball 5-10 times), 5 months after the operation I increased physical activity to 50% of the previous: gymnastics for 1 hour 30 minutes (72 exercises, 2300 movements) and dosed walking for 1 hour 30 minutes at a pace of steps per minute. I perform them only once in the first half of the day, and not twice, as before. In 5 months after repeated bypass surgery, I walked 867 km. At the same time, I conduct auto-training sessions twice a day, which help me relax, relieve tension and restore performance. My gym equipment so far includes a chair, two gymnastic sticks, a ribbed roller, a roller massager and an inflatable ball. I stopped at these loads until the causes of angina manifestations were fully clarified.

Of course, the CABG operation itself, not to mention a repeat operation, its unpredictable consequences, possible postoperative complications create great difficulties for the operated person, especially in organizing physical training. He needs help, and not just medication. He needs a minimum of information about his disease in order to competently build his future life and avoid undesirable consequences. I hardly came across the information I needed. Even in M. DeBakey’s book with the intriguing title “A New Life of the Heart,” the chapter “Healthy Lifestyle” talks mainly about eliminating risk factors and improving lifestyle (diet, weight loss, limiting salt intake, quitting smoking). Although the author pays tribute to physical exercise, he warns that excessive stress and sudden overload can end tragically. But nothing is said about what excessive loads are, how they are characterized and how to live with a “new heart”.

Articles by N.M. helped me develop a competent approach to organizing physical training. Amosova and D.M. Aronov, as well as K. Cooper and R. Gibbs, although all of them were devoted to the prevention of heart attack using jogging and did not affect CABG operations.

The main thing that I managed to do was maintain mental activity and creative activity, maintain a spirit of cheerfulness and optimism, and all this, in turn, helped me gain the meaning of life, faith in myself, in my ability to improve and self-discipline, in the ability to take responsibility for your life in your own hands. I believe that there is no other way and I will continue to continue my observations and experiments, which help me overcome emerging health difficulties.

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Physical activity after surgery

Coronary heart disease (CHD) is one of the main causes of mortality in developed countries. According to summary data, as a result of coronary heart disease, every year humanity loses more than 2.5 million people, more than one third of which are people of working age

Coronary artery bypass surgery (CABG) is currently the most effective method of treating coronary artery disease, improving the quality and life expectancy of patients and reducing the risk of developing possible complications of the disease. Restoring normal lumen in the most damaged vessels will relieve patients from debilitating angina pain, from the need for constant use of nitroglycerin and other drugs, but no matter how radical the surgeons are, they are not able to either restore the normal structure of the vascular wall or stop the progression of the underlying disease - coronary artery disease atherosclerosis. But to a certain extent, this is within the power of the patients themselves if they follow the appropriate recommendations: a healthy lifestyle, combating risk factors that contribute to the progression of coronary heart disease (smoking, hypercholesterolemia, arterial hypertension, as well as excess body weight, physical inactivity, etc.).

It is obvious that the positive results of the operation will last for many years only if the necessary amendments are made to the lifestyle, giving up bad habits, and the active participation of patients in preventive measures aimed at maintaining health. Carrying out complex rehabilitation measures helps to optimize the results of CABG, more complete and rapid improvement of the quality indicators of the cardiovascular and respiratory systems and restoration of working capacity. Physical training is mandatory for all patients who have undergone CABG. However, the timing of the start of physical rehabilitation, its intensity and nature are determined strictly individually.

After discharge from the hospital, the patient is observed by a cardiologist at his place of residence or transferred to a sanatorium. At the dispensary stage of rehabilitation, treatment and preventive measures and physical rehabilitation continue based on selected recommendations in the cardiac surgery hospital and sanatorium. Physical rehabilitation should be built depending on the group of physical activity of patients and includes: morning hygienic exercises, therapeutic exercises, measured walking, measured climbing stairs.

Morning hygienic gymnastics (UGG).

The main task of UGG is to activate peripheral blood circulation and gradually engage all muscles and joints, starting with the feet and hands. All exercises of a training nature, exercises with weights (bending over, squats, push-ups, dumbbells, etc.) are excluded from UGG, since this is the task of therapeutic gymnastics.

Starting position - lying on the bed, sitting on a chair, standing against a support, standing - depending on the patient’s well-being. The pace is slow. The number of repetitions of each exercise is times. UGG time is from 10 to 20 minutes, carried out daily before breakfast.

Therapeutic gymnastics (LG).

One of the most important tasks of LH is to train extracardiac circulatory factors to reduce the load on the myocardium.

Dosed physical activity causes the development of the vascular network in the heart and reduces cholesterol levels in the blood. Thus, the risk of thrombosis is reduced. Physical activity must be strictly dosed and regular.

Therapeutic exercises are performed daily and cannot be replaced by other types of physical activity. If, when performing exercises, discomfort occurs behind the sternum, in the heart area, or shortness of breath appears, it is necessary to reduce the load. However, to achieve a training effect, if the complex is performed easily, the load is gradually increased. Only a gradually increasing load ensures the body is trained, helps improve its functions, and prevents exacerbation of the disease. A correct gradual increase in physical activity contributes to faster adaptation of the heart and lungs to new circulatory conditions after CABG. The recommended set of physical exercises is performed minutes before meals or 1-1.5 hours after meals, but no later than 1 hour before bedtime. Exercises must be performed at the recommended pace and number of repetitions.

We recommend indicative complexes of therapeutic exercises at home of varying degrees of complexity: I - for the first three months after discharge from the hospital; II - for 4-6 months. and III- for 7-12 months after discharge from the hospital.

The LH procedure begins in the water part with breathing exercises. Thanks to the work of the respiratory muscles, the diaphragm, and changes in intrathoracic pressure, blood flow to the heart and lungs increases. This improves gas exchange, redox processes, and prepares the cardiovascular and respiratory systems for increased load. One of the main breathing exercises is diaphragmatic breathing, which should be done at least 4-5 times a day. How to perform it correctly: starting position lying on a bed or sitting on a chair, relax, put one hand on your stomach, the other on your chest; take a calm breath through the nose, inflating the stomach, while the hand lying on the stomach is raised, and the second one, on the chest, should remain motionless. Inhalation duration is 2-3 seconds. When you exhale through a half-open mouth, the stomach releases. The duration of exhalation is 4-5 seconds. After exhaling, there is no need to rush to inhale again, but should pause for about 3 seconds until the first desire to inhale appears. In the main part of the LH procedure, it is necessary to observe the correct order of inclusion of various muscle groups (small, medium, large). A gradual increase in load helps to strengthen central, peripheral blood circulation, lymph circulation and more rapid recovery of strength, increases the body's resistance. The LH procedure should be completed with complete muscle relaxation and calm breathing.

Monitoring the effectiveness of the procedure is carried out according to the pulse count, the nature of its filling, the time of return to the original values, and general well-being.

When performing 1 LH complex, it is allowed to increase the pulse rate to 15-20% of the initial value; II - up to 20-30% and III - up to 40-50% of the original value. Restoring the pulse to its original values ​​within 3-5 minutes indicates an adequate response.

The pace of the exercises is slow, medium.

Particular attention is paid to proper breathing: inhale - while straightening the torso, abducting the arms and legs; exhale - when bending; adduction of arms and legs. Avoid holding your breath, avoid straining.

Approximate complex of therapeutic exercises N 1

for home exercises (1-3 months after coronary artery bypass surgery)

Starting position (I.p.)

Sitting, hands on knees, legs slightly apart

Raising your arms to the sides (inhale), returning to the starting position (exhale)

Inhale for 1-2, exhale

Sitting, arms bent at elbows at right ANGLES

Circular movements with the brushes in both directions

5-7 times each way

After the exercise, shake your hands

Sitting, hands on knees, legs slightly apart

Simultaneously raising both feet on the toes, then lowering them onto the heels while lifting

Abduction of the right arm to the side with a slight rotation of the body and head (inhale), return to the p. (exhale)

24 times each way

Don't strain your muscles

Spreading your legs to the sides by stepping from heels to toes and returning to i. in the same way

Don't strain your muscles

Sitting on the edge of a chair, leaning against the back, left hand on your stomach, right hand on your chest

When you inhale, the abdominal wall protrudes, when you exhale, it retracts.

Sitting, hands at shoulder joints

Circular movements at the shoulder joints

Sitting on the edge of a chair, leaning against the back, holding the seat of the chair with your hands, one leg straightened, the other bent and placed on the toe under the chair

3 i. p. - inhale, while exhaling, change the position of the legs several times

After the exercise, rest break

Sitting, hands on knees, legs shoulder-width apart

3 i. p. - inhale: while exhaling, bend over to your right leg, placing both hands on your knee, return to i. p. (inhale)

4-5 times each way

Straightening your torso. watch your back position

I. p. - sitting, arms down. legs slightly apart

Alternately pulling the knee to the stomach in combination with exhalation. return to i. p. - inhale

2-3 times with each leg

If there is difficulty, limit yourself to raising your knee high

Sitting, hands on waist, legs slightly apart

In and. p. - inhale, while exhaling stand up, then sit down

When standing up for the last time, remain in a standing position.

Standing behind the back of a chair

Raising your arms to the sides (inhale), lowering your arms onto the seat of a chair and leaning forward (exhale)

Relax while bending

Standing sideways to the back of a chair, holding onto it with your left hand

Freely swing the relaxed right leg back and forth. Turn around, do the same with your left foot

Pump your leg 4-6 times

Don't hold your breath

Standing behind the back of a chair, holding it with your hands

Alternate abduction of arms with a slight rotation of the torso in the same direction

2-3 times in each direction

When turning to the side - inhale, return to i. p. - exhale

"Roll" from heels to toes and back

A blurry swing of the leg to the side and a return to i. n. Then do the same with the other leg

2-4 times each way

Breathing freely

Standing, feet shoulder-width apart, arms down

In and p. - inhale: during exhalation, tilt the torso to the SIDE with sliding of the arms along the body (“pump”) and return to i. P.

3-4 times in each direction

Stay straight, don't lean forward

Standing behind the back of a chair, 11 holding it with your hands

Squats with hands supporting the back of a chair and returning to i. P.

Keep your back straight

Standing, arms down

Raising your arms to the sides - - inhale: lowering the rue down with a slight tilt of the torso forward - exhale

Put your hands down and relax

Standing, arms down

Walking with gradual acceleration and subsequent deceleration

Inhale for 2 steps, exhale for 4 steps

Sitting leaning against the back of a chair

Calm inhalation and full exhalation

Lesson duration min.

Therapeutic gymnastics complex N 2

for home exercises 4-6 months after coronary artery bypass surgery

Starting position (I.p.)

Sitting, hands on knees, palms up

Clenching your fingers into fists while bending your feet

Sitting, hands on knees

Bend your arms to your shoulders, straighten them forward, bend your arms to your shoulders, spread them to the sides, return them to a

Sitting, hands on waist

Stepping your feet sideways in a herringbone pattern and back again

Sitting, left hand on the belt, right hand on the chest

Breathe deeply with the right lung, then, changing position, breathe with the left lung

Exhale for a long time

Sitting, hands on waist

Rotate the body first to the left, then to the right

Sitting, hands on waist, one leg under the chair, the other in front

Changing the position of your feet (you can slide your feet along the floor)

Sitting, one hand on the chest, the other on the stomach

Exhale for a long time

Sitting, hands to shoulders

Circular movements with bent arms

1 0 times forward and backward

When moving the route up, inhale, down, exhale.

Sitting hands on belt

Bicycle movements with one leg, then with the other leg

Alternately pulling the knee to the chest, followed by spreading the rue to the sides

When you spread your arms, inhale, when you pull up your knee, exhale.

Standing, lean your hands on the back of the chair

Rolling from toes to heels

Alternately moving your legs back

4-6 times with each leg

Keep your back straight

Standing, arms down

Raising your arms to the sides in combination with inhalation, returning to the starting position with exhalation

Keep your back straight

Standing, lean your hands on the back of the chair

Alternately moving the legs to the side

4-5 times with each leg

Keep your back straight, breathe freely

Hands on waist, feet shoulder-width apart

Torso rotation to the left, then to the right

5-6 times in each direction

Rotation of the torso to the side with abduction of the same arm

When turning to the side, inhale when returning to i. I - exhale

Standing, with a gymnastic stick in hands

Raise the stick up, inhale, lower the stick down - exhale

When lifting a stick, stretch upward

Standing, stick vertically

Leaning your hands on the pack, alternately rotate your straight leg (forward - to the side - back)

4-6 times with each leg

Standing, stick horizontally

Raise the stick up, lower it onto your shoulders behind your head, lift it up, lower it forward

When lifting the stick up, inhale; when lowering, inhale.

Stick behind head, feet shoulder-width apart

Turn the body to the left, then to the right

Inhale when turning

Standing, stick in front horizontally

Half squat with jackdaw raised forward

Exhale when squatting

Standing, jackdaw vertically

Alternately moving the arm to the side

Inhale when abducting your arm

Standing, stick vertically, one leg bent in front (lunge forward)

Spring squats on one leg, then, changing the position of the legs, squats on the other leg

4 times on each leg

Standing, hold the stick by the middle in one hand

Rotating the stick in your hand, then changing the position of your hands, rotating the pack in the other hand

Breathing is free. Hold the stick tightly without relaxing your fingers

Walking in place

Sitting. One hand on the chest, the other on the stomach

Sitting. Put one foot on top of the other

10 times with each leg

Raising the rue upward in combination with breathing

When raising your hands up - inhale, when lowering - exhale

Sitting, one foot on the toe, the other on the heel, hands on the belt

Changing leg position

Sitting, one hand on the chest, the other on the stomach

Lesson duration min.

therapeutic exercises for home exercises (7-12 months after coronary artery bypass surgery)

Starting position (I.p.)

Standing, arms down

Walking on toes, heels, feet with arms raised up, to the sides, down

Standing, arms down

Raising your arms to the sides - inhale, "coachman's" movements of the arms - exhale

As you exhale, press lightly on your chest

Standing. hands on the belt

Torso rotations with arms abducted to the sides) with tension

Keep your body straight

Standing, hands on belt

Squat, arms forward

Don't lean forward

Standing, hands on chest

Deep chest breathing

Don't hold your breath

Standing, arms down

Jogging with transition to walking with slowdowns

Standing, gymnastic pack on shoulder blades

Springy bends of the torso to the sides (while exhaling)

When straightening the body - inhale

Standing, gymnastic stick in hands

Alternately pulling the bent leg towards the stomach. On the exhale

Pressing the folder to encourage exhalation

Standing, gymnastic stick on shoulder blades

Bend the torso forward while exhaling

Don't lower your head

Standing, hold the gymnastic stick vertically in your hand by the middle

Alternate rotation of the brush 180°

Standing, arms down

Standing, hands on belt

Body rotation right and left

Standing, one hand on the chest, the other on the stomach

Chest and diaphragmatic breathing

Standing, stick horizontally in hands

Stepping over a stick

Standing, arms bent at the elbows, fingers clenched into fists

Standing, arms down

Shaking hands day muscle relaxation

Standing, arms down

Jogging with transition to slow walking

Don't hold your breath

Standing, hands behind heads

Springy side bends of the torso

Do not lean your torso forward

Standing, arms to the sides, hands in fists

Copying small, medium and large circles by hand

Standing, arms down

Alternately raising your arms up, inhaling

When you raise your hands, look at them

Abduction of the right arm and leg to the sides) and back. Same with left leg and hand

Standing, feet shoulder-width apart, holding the back of a chair

Don't hold your breath

Sitting, arms down

Rotational movements of the head

Avoid dizziness

Sitting, arms down

Alternating shaking of arms and legs

Sitting, arms down

Complete muscle relaxation

Strength, hands on knees

Lesson duration min.

Great importance is attached to both the inpatient and outpatient stages of rehabilitation to the use of such natural movement as walking. Dosed walking increases the vitality of the body, strengthens the heart muscle, improves blood circulation, breathing and leads to increased physical performance. When walking in doses, you must follow the following rules:

1. You can walk in any weather, but not below the air temperature of -20°C or. -15°C with wind.

2. The best walking time: from 11 to 13 hours and from 17 to 19 hours.

3. Clothes and shoes should be loose, comfortable, and light.

4. It is prohibited to talk or smoke while walking.

When doing measured walking, it is also necessary to keep a self-monitoring diary, where the pulse is recorded at rest, after exercise and after rest after 3-5 minutes, as well as general well-being. Method of measured walking:

1. Before walking, you need to rest for 5-7 minutes and count your pulse.

2. The pace of walking is determined by the patient’s well-being and heart performance. First, a slow walking pace of -sh/min is mastered, with a gradual increase in distance, then an average walking pace of -sh/min, also gradually increasing the distance, and then a fast pace - 100-110 sh/min. You can use the intersal type of walking, i.e. alternating walking with acceleration and deceleration.

3. After leaving home, it is first recommended to walk at least 100 meters at a slower pace, one minute slower than the walking pace that the patient is currently mastering, and then switch to the mastered pace. This is necessary in order to prepare the cardiovascular and respiratory systems for a more serious load. You should also finish walking at a slower pace.

Without mastering the previous motor mode, it is not recommended to move on to mastering a new one; load.

Equally important at all stages of rehabilitation is given to measured ascents to the steps of the stairs.

Almost all patients at home or due to their occupation are faced with the need to climb stairs.

Descending stairs counts as 30% of the ascent. The walking pace is slow, no faster than 60 steps per minute. You need to walk at least 3-4 times a day. Just like with any training load, patients keep a self-monitoring diary.

Social and labor aspect of rehabilitation.

One of the important indicators of the effectiveness of CABG surgery is the restoration of working capacity of operated patients.

After discharge from the hospital (during the first 3-4 months after surgery), patients are not recommended to: lift and carry weights of more than 5 kg, repair work, work involving bending, with fast and sudden movements. But you can’t exclude yourself from work, do everything according to how you feel and with rest. We must adhere to the golden mean: do not overload the heart muscle, but also do not leave it in a state of inactivity.

It should be borne in mind that for patients with coronary artery disease who have undergone CABG surgery, regardless of their condition, work associated with significant physical stress, even episodic, with constant moderate physical stress (long walking, night shift work) is contraindicated. Work at heights, under water, on a conveyor belt, work with exposure to toxic substances, acids, alkalis, etc., work in adverse weather conditions, work related to driving is contraindicated.

In addition to movements, positive emotions are also needed. If the patient cannot return to his job, then try to find a psychologically less stressful job or a job associated with less physical activity, or switch to part-time work, or try to find something to do at home.

And I would like to end with the words said by the director of the Human Reproduction Center A.S. Hakobyan: “Of course, medicine can do a lot. But we must not forget: a person’s life program is determined only 15% by the level of health care, 20% by genes, and the remaining 65% by lifestyle. No creature has such self-destructive tendencies as man. I think by adjusting your lifestyle, you can double your walk on Earth.” Lifestyle depends only on ourselves, changing a chaotic, idle lifestyle to a healthy one does not require material costs, it is enough to make a little effort on yourself, show will and patience.. In the regional clinical cardiology clinic, experienced, highly qualified specialists - cardiologists, surgeons, rehabilitation specialists together We are ready to develop an individual, comprehensive rehabilitation program with you, monitor its implementation and effectiveness, and also resolve issues of your ability to work and professional orientation.

In February of this year, I came across the article “Shunts do not last forever.” A correspondent for the Evening Moscow newspaper talked with the head of the laboratory of X-ray endovascular methods of the Cardiology Research Center, Doctor of Medical Sciences A.N. Samko. The discussion was about the effectiveness of coronary artery bypass grafting (CABG) operations. Dr. Samko painted a bleak picture: after a year, 20% of shunts close, and after 10 years, as a rule, all of them! In his opinion, repeat bypass surgery is risky and extremely difficult. This means that life is guaranteed to be extended by only 10 years.

My experience as a long-time cardiac surgical patient who has undergone two coronary artery bypass operations suggests that these periods can be increased, primarily through regular physical activity.

I view my illness and operations as a challenge from fate that must be actively and courageously resisted. Unfortunately, physical activity after CABG is mentioned only in passing, by the way. Moreover, there is an opinion that some patients after heart surgery live safely and for a long time without making any effort. I have never met such people. What I want to talk about is not a miracle, not luck or a fortunate coincidence, but a combination of the high professionalism of the doctors of the Russian Scientific Center for Surgery and my perseverance in implementing my own program of restrictions and loads (RON).

My story is this. Born in 1935. In his youth he suffered from malaria for many years, and during the war from typhus. Mother - a heart patient, died at 64 years old.

In October 1993, I suffered an extensive transmural posterolateral myocardial infarction of the left ventricle, and in March 1995 I underwent coronary artery bypass grafting - 4 shunts were sewn in. Thirteen years later, in April 2008, angioplasty of one shunt was performed. The other three were functioning normally. And after 14 years and 3 months, I suddenly started having angina attacks, which I had never had before. I went to the hospital, then to the Scientific Cardiology Center. I underwent further examination at the Russian Scientific Center for Surgery. The results showed that only two of the four shunts were functioning normally, and on September 15, 2009, Professor B.V. Shabalkin performed a repeat coronary artery bypass surgery on me.

As you can see, I have been able to significantly extend the average life expectancy with shunts, and I am convinced that I owe this to my RON program.

Doctors still consider my post-operative physical activity too high and advise me to rest more and take medication constantly. I can't agree with this. I want to make a reservation right away - there is a risk, but it is a justified risk. Understanding the seriousness of my situation, from the very beginning I introduced certain restrictions into my system: I excluded jogging, exercises with dumbbells, on the horizontal bar, hand push-ups and other strength exercises.

Typically, clinic doctors classify CABG surgery as an aggravating factor and believe that the person undergoing surgery has only one destiny: to live out his life quietly and calmly and constantly take medications. But bypass surgery ensures normal blood supply to the heart and the body as a whole! And how much work has been invested, effort and money spent to save the patient from death and give him the opportunity to live on!

I am convinced that even after such a difficult operation, life can be fulfilling. And I can’t come to terms with the categorical statements of some doctors that my workload is excessive. They are feasible for me. But I know that if atrial fibrillation appears, severe pain in the heart area, or the lower limit of blood pressure exceeds 110 mm Hg, you must immediately call an ambulance doctor. Unfortunately, no one is immune from this.

My RON program includes five points:

1. Physical training, constant and gradually increasing to a certain limit.

2. Dietary restrictions (mainly anti-cholesterol).

3. Gradually reduce your medications until you stop taking them completely (I only take them in emergencies).

4. Prevention of stressful conditions.

5. Constantly being busy with interesting things, leaving no free time.

Gaining experience, I gradually increased physical activity, included new exercises, but at the same time strictly controlled my condition: blood pressure, heart rate, did an orthostatic test, a test for heart fitness.

My daily physical activity consisted of measured walking (3-3.5 hours at a pace of 138-140 steps per minute) and gymnastics (2.5 hours, 145 exercises, 5000 movements). This load (metered walking and gymnastics) was performed in two doses - in the morning and in the afternoon.

Seasonal loads were added to the daily loads: skiing with stops every 2.5 km to measure heart rate (total 21 km in 2 hours 15 minutes at a speed of 9.5 km per hour) and swimming, one-time or fractional - 50- 200 m (800 m in 30 minutes).

In the 15 years since my first CABG operation, I have walked 80 thousand kilometers, covering a distance equal in length to two equators of the earth. And until June 2009, I didn’t know what angina attacks or shortness of breath were.

I did this not out of a desire to demonstrate my exclusivity, but because of the conviction that blood vessels, natural and artificial (shunts), fail (clog) not from physical exertion, especially strenuous ones, but due to progressive atherosclerosis. Physical activity inhibits the development of atherosclerosis, improves lipid metabolism, increasing the content of high-density cholesterol (good) in the blood and reducing the content of low-density cholesterol (bad) - thereby reducing the risk of blood clots. This is very important for me, since my total cholesterol levels fluctuate at the upper limit. The only thing that helps is that the ratio of high and low density cholesterol, the content of triglycerides and the cholesterol coefficient of atherogenicity never exceed the established standards.

Physical exercises, gradually increasing and giving an aerobic effect, strengthen muscles, help maintain joint mobility, increase minute blood output, reduce body weight, have a beneficial effect on intestinal function, improve sleep, increase tone and mood. In addition, they help in the prevention and treatment of other age-related diseases - prostatitis, hemorrhoids. A reliable indicator that the load is not excessive is nasal breathing, so I breathe only through my nose.

Everyone is sufficiently informed about measured walking. But I would still like to cite the opinion of a famous surgeon, who himself was not involved in sports, but was fond of hunting, to confirm its usefulness and effectiveness. And hunting means walking for many hours. We will talk about Academician A.V. Vishnevsky. Since his student years, fascinated by anatomy and having perfectly mastered the art of dissecting, he loved to tell his acquaintances all sorts of interesting details. For example, there are 25 joints in each human limb. With each step, 50 articulated sections are thus set in motion. The 48 joints of the sternum and ribs and the 46 bony surfaces of the spinal column do not remain at rest. Their movements are barely noticeable, but they are repeated with every step, with every inhalation and exhalation. Considering that there are 230 joints in the human body, how much lubricant do they need and where does this lubricant come from? Having asked this question, Vishnevsky answered it himself. It turns out that the lubricant is supplied by a pearly-white cartilaginous plate that protects the bones from friction. There is not a single blood vessel in it, and yet the cartilage receives nutrition from the blood. In its three layers there is an army of “builder” cells. The upper layer, which wears out due to friction of the joints, is replaced by the lower ones. This is similar to what happens in the skin: with each movement, the clothing erases dead cells from the surface layer, and they are replaced by underlying ones. But the cartilage-former does not die ingloriously, like a skin cell. Death transforms him. It becomes soft and slippery, turning into a lubricant. This way, a uniform layer of “ointment” is formed on the rubbing surface. The more intense the load, the more “builders” die and the faster the lubricant is formed. Isn't this a walking hymn!

After the first CABG operation, my weight remained between 58-60 kg (with a height of 165 cm), I took medications only in emergency cases: with increased blood pressure, temperature, heart rate, headaches, and arrhythmia. The main difficulty for me was my easily excitable nervous system, which I practically could not cope with, and this affected the results of the examinations. A sharp increase in blood pressure and heart rate due to anxiety misled doctors about my actual physical capabilities.

After analyzing statistical data from long-term physical training, I determined the optimal heart rate for my operated heart, guaranteeing the safety and aerobic effect of physical exercise. My optimal heart rate is not unambiguous, like Cooper’s; it has a wider aerobic range of values, depending on the type of physical activity. For gymnastic exercises - 94 beats/min; for measured walking - 108 beats/min; for swimming and skiing - 126 beats/min. I rarely reached the upper limits of my heart rate. The main criterion was that the restoration of the pulse to its original value was, as a rule, rapid. I want to warn you: the optimal pulse recommended by Cooper for a 70-year-old man - 136 beats / min - after myocardial infarction and CABG surgery is unacceptable and dangerous! The results of long-term physical training confirmed every year that I was on the right path, and the conclusions made after the first CABG operation were correct.

Their essence is as follows:

The main thing for the operator is a deeply conscious understanding of the significance of the CABG operation, which saves the patient by restoring normal blood supply to the heart muscle and gives him a chance for the future, but does not eliminate the cause of the disease - vascular atherosclerosis;

The operated heart (CABG) has great potential, which manifests itself with a properly selected lifestyle and physical training, which should be done constantly;

The heart, like any machine, needs to be trained, especially after a myocardial infarction, when more than 25% of the heart muscle has turned into scar, and the need for normal blood supply remains the same.

Only thanks to my lifestyle and physical training system I managed to maintain good physical shape and undergo repeat CABG surgery. Therefore, in any conditions, even in the hospital, I always tried not to stop physical training, albeit in a reduced volume (gymnastics - 10-15 minutes, walking around the ward and corridors). While in the hospital, and then in the Cardiology Research Center and the Russian Research Center for Surgery, I walked a total of 490 km before the repeat CABG operation.

Two of my four shunts, installed in March 1985, survived for 14.5 years with the help of physical training. This is a lot compared to the data in the article “Shunts are not forever” (10 years) and the statistics of the Russian Scientific Center for Surgery (7-10 years). So the effectiveness of controlled physical activity for myocardial infarction and coronary artery bypass surgery seems to me to be proven. Age is not a barrier. The need and volume of physical activity should be determined by the general condition of the operated patient and the presence of other diseases that limit his physical activity. The approach must be strictly individual. I was very lucky in that I always had an intelligent, sensitive and attentive doctor next to me - my wife. She not only observed me, but also helped me overcome both medical illiteracy and fear of a possible negative reaction of the cardiovascular system to constantly increasing physical activity.

Experts say that repeat operations pose a particular challenge for surgeons around the world. After my second operation, my rehabilitation did not proceed as smoothly as the first time. Two months later, some signs of angina appeared with this type of exercise, such as measured walking. And although they were easily removed by taking one tablet of nitroglycerin, this really puzzled me. Did I understand? that it is impossible to draw hasty conclusions - too little time has passed since the operation. And rehabilitation began in the sanatorium already on the 16th day (after the first operation, I began more or less active actions 2.5 months later). In addition, it was impossible not to take into account that I had become 15 years older! All this is true, but if a person, thanks to his system, achieves certain positive results, he is inspired and confident. And when fate throws him back overnight, making him vulnerable and helpless, this is a tragedy associated with very strong emotions.

Having pulled myself together, I began to work out a new program of life and physical training and quickly became convinced that my work was not in vain, since the main approaches remained the same, but the volume and intensity of the loads would have to be increased more slowly, taking into account my new condition and in conditions of strict control over it. Starting with slow walks and 5-10-minute gymnastic warm-ups (head massage, rotational movements of the pelvis and head, inflating the ball 5-10 times), 5 months after the operation I increased physical activity to 50% of the previous: gymnastics for 1 hour 30 minutes (72 exercises, 2300 movements) and dosed walking for 1 hour 30 minutes at a pace of 105-125 steps per minute. I perform them only once in the first half of the day, and not twice, as before. In 5 months after repeated bypass surgery, I walked 867 km. At the same time, I conduct auto-training sessions twice a day, which help me relax, relieve tension and restore performance. My gym equipment so far includes a chair, two gymnastic sticks, a ribbed roller, a roller massager and an inflatable ball. I stopped at these loads until the causes of angina manifestations were fully clarified.

Of course, the CABG operation itself, not to mention a repeat operation, its unpredictable consequences, possible postoperative complications create great difficulties for the operated person, especially in organizing physical training. He needs help, and not just medication. He needs a minimum of information about his disease in order to competently build his future life and avoid undesirable consequences. I hardly came across the information I needed. Even in M. DeBakey’s book with the intriguing title “A New Life of the Heart,” the chapter “Healthy Lifestyle” talks mainly about eliminating risk factors and improving lifestyle (diet, weight loss, limiting salt intake, quitting smoking). Although the author pays tribute to physical exercise, he warns that excessive stress and sudden overload can end tragically. But nothing is said about what excessive loads are, how they are characterized and how to live with a “new heart”.

Articles by N.M. helped me develop a competent approach to organizing physical training. Amosova and D.M. Aronov, as well as K. Cooper and R. Gibbs, although all of them were devoted to the prevention of heart attack using jogging and did not affect CABG operations.

The main thing that I managed to do was maintain mental activity and creative activity, maintain a spirit of cheerfulness and optimism, and all this, in turn, helped me gain the meaning of life, faith in myself, in my ability to improve and self-discipline, in the ability to take responsibility for your life in your own hands. I believe that there is no other way and I will continue to continue my observations and experiments, which help me overcome emerging health difficulties.

Arkady Blokhin

Coronary heart disease is a chronic disease leading to myocardial infarction. During ischemia, the coronary arteries that supply the heart muscle are affected, and cholesterol is deposited on them. Gradually, the lumen of the blood vessels begins to narrow, and an insufficient amount of oxygen reaches the heart.

Patients complain of pain behind the sternum, in the area of ​​the heart muscle. After such a process, there is a danger of necrosis of the tissue and organ as a whole. Angina pectoris or “angina pectoris” is diagnosed. What can this lead to, and how long do patients with cardiovascular disease live?

Affected blood vessels of the heart muscle lead to wear and tear and require immediate renewal.

To do this, vascular grafts called shunts are inserted. These tissues are taken from the patient's chest artery, the radial artery in the arm, or the great leg vein.

Cardiac surgeons about bypass surgery

Until recently, this vital operation was available only to financially secure patients. For others, such treatment was a fairy-tale fantasy and the result was unpredictable. How long can you live after replacing coronary arteries? There are many questions and they all require an unambiguous answer.

Bypass surgery

Long before the operation, preparatory measures and conversations are carried out with patients. The patient should know about the stages of the operation and the course of the recovery period. For a positive outcome after a surgical procedure, a large share of responsibility falls on the person being operated on. Therefore he must know some aspects such as:

Life after

A person who walked along the edge of danger and remained to live understands how long he will have to live on this earth after the operation depends on him. How do patients live after surgery, what can one hope for? How, how long will bypass surgery take to live?

There cannot be a definite answer, due to the different physical condition of the body, the timeliness of surgical intervention, the individual characteristics of a person, the professionalism of surgeons, and the implementation of recommendations during the recovery period.

Basically, the answer to the question: “How long do they live?” There is. You can live 10, 15 or more years. It is necessary to monitor the condition of the shunts, visit the clinic, consult a cardiologist, get examined on time, follow a diet, and lead a calm lifestyle.

Important criteria will be a person’s character traits - positivity, cheerfulness, efficiency, desire to live.

Sanatorium treatment

After surgery, restoration of health is indicated in specialized sanatoriums under the supervision of trained medical personnel. Here the patient will receive a course of procedures aimed at restoring health.

Diet

A positive result after surgery depends on many reasons, including adherence to a special diet. Heart bypass surgery is a serious intervention in the vital functions of the body, and therefore has certain obligations that the patient must fulfill, these are:

• doctor's recommendations;
• maintain the recovery period in intensive care;
• complete cessation of bad habits such as smoking and alcohol;
• refusal of the usual diet.

As for following a diet, there is no need to be upset. The patient moves away from the usual home-cooked meals and moves on to completely eliminating foods containing fats - fried foods, fish, butter, margarine, ghee and vegetable oils.

After bypass surgery, all dishes are seasoned with olive oil, cold-pressed.

Thus, the patient will avoid recurrence of cholesterol plaques on the vessels. The menu will be enriched with turkey and poultry meat.

After surgery, it is recommended to include more fruits and fresh vegetables. Every day you should take a glass of freshly squeezed orange juice (fresh). Walnuts and almonds will decorate the diet with their presence. Any fresh berries won’t hurt either; blackberries are especially good for the heart, as they supply the body with antioxidants. These elements lower dietary cholesterol levels.

Add fresh greens to your daily menu, which can be grown not only in the garden, balcony, but also on the windowsill in winter. Spinach is rich in folic acid, minerals and vitamin complex.

You should not eat fatty dairy products, except skim milk and low-fat cheeses. It is recommended not more than 200 grams of kefir per day, but low-fat.

Replace delicious buns, white bread rolls and other products prepared in margarine or butter with puddings.

After the operation, Coca-Cola, Pepsi, and sweet soda are excluded. Filtered water and mineral water will be used for a long time. Tea and coffee without sugar or sucrose are possible in small quantities.

Take care of your heart, take more care of it, follow a culture of proper nutrition, and do not abuse alcoholic beverages, which will lead to the development of cardiovascular diseases.

Complete cessation of bad habits. Smoking and alcohol destroy the walls of blood vessels. Implanted shunts “live” no more than 6-7 years and require special care and attention.

Reviews from patients and doctors

Svetlana, 45 years old. She was admitted to the cardiology center with suspected coronary artery disease. Complaints of short-term pain in the heart area, pressing in nature, radiating to the left arm and shoulder blade. General weakness, leading to fainting.

Before this, she had been treated in a hospital several times and was undergoing medical examination by a cardiologist. Completed a course of therapeutic treatment with drugs that reduce blood clotting; adrenergic blockers that reduce the load on the heart.

After 12 years, heart bypass surgery was proposed. After the rehabilitation period, I returned to work, but with a lighter schedule and a short workday. The pain stopped and the condition returned to normal.

Valentin, 61 years old. More than 8 years have passed since the first bypass surgery. They are worn out and require replacement. I contacted the Heart Center in Moscow. He was examined and prepared for surgery.

I would like to thank the doctors of the Center for their attentive attitude and clarification about the progress of the operation. Now my condition has returned to normal, I am waiting for discharge. It is recommended to undergo a rehabilitation course in a sanatorium in the Moscow region after six months.

Scientific Center for Vascular Surgery of the Russian Academy of Medical Sciences named after. Bakuleva

We are patients of the cardiology department located on the 8th floor. We would like to thank the medical staff for their attentive attitude towards patients, timely examination, recommendations after bypass surgery, and adherence to routine procedures.

Mamedov R., Belokuryev T., Belov A., Zernov V.

City Hospital No. 2 of Astana

According to statistics from practicing doctors, a large percentage of mortality is caused by atherosclerosis of the coronary arteries and cardiac ischemia. Since November 2013, the hospital’s cardiac surgeons began to introduce the surgical method of coronary bypass grafting.

A unique method in which surgery is performed on a beating heart without the use of a heart-lung machine. This makes surgical treatment possible for many patients who had limitations.

Hospital surgeons perform a bypass to bypass the affected area of ​​the artery using the internal mammary artery. The high survival rate gives hope to many patients.