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    Heart Bypass FAQ

    How is bypass surgery done?

    Doctors take a substitute blood vessel from another part of the body. It's safe to do this because the body has other ways of getting blood to areas.

    The surgeon then attaches one end of the graft to the aorta and the other end to the coronary artery below the blockage.

    The traditional operation calls for a six- to eight-inch cut down the center of the breastbone so the surgeon can get directly at the heart. During the operation, the body is connected to a heart-lung bypass machine that keeps the blood flowing. The heart is stopped while the doctor operates. Then the surgeon uses special wires to close the chest.

    Sometimes it's possible for the surgeon to use minimally invasive surgical techniques. In this case, the incision is much smaller. And in some cases, the heart does not even have to be stopped. However, these techniques can't be used for all bypass surgeries.

    How risky is bypass surgery?

    In a relatively young patient -- such as former President Clinton -- who has no underlying diseases such as diabetes, the risk of bypass surgery is small.

    "In skilled hands, the surgery can be carried out with overall risk of 1% to 2% of anything untoward happening," Shah says. "This varies according to age, how badly damaged the heart is, whether the aorta itself has plaque buildup -- a number of factors. But I think driving a car every day is more dangerous."

    How long does it take to recover?

    Once the bypass surgery is completed, doctors start the heart again with electric shocks and turn off the heart-lung machine.

    The patient will have wires to monitor the heart pace and a tube to drain fluids leading from the chest. Sometimes a temporary pacemaker is attached to the wires and to the chest.

    After surgery, the patient goes to an intensive care unit for a day or two of close monitoring. Then the patient is transferred to the nursing unit for three to five days.

    Recovery from bypass surgery can be surprisingly rapid.

    "With uncomplicated surgery in a person of President Clinton's age -- if his heart muscle is not damaged -- you can be out of the hospital in five days," Shah says. "If they say he has an excellent chance of full recovery, he would be an excellent candidate for fast recovery. I would say he has only a 1% to 1.5% risk of anything bad happening."

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