Mr. Chen, 37 years old, had narrowing of three blood vessels feeding his heart and could not have a stent placed. The surgeon performed bypass surgery to save the severely damaged heart muscle.
MSc.BS.CKII Huynh Hoang Khang, Head of the Department of Cardiovascular Surgery, Interventional Cardiology Center, Tam Anh General Hospital, Ho Chi Minh City, said that coronary artery disease that occurs before the age of 45 like Mr. Chen is classified as “young people”, accounting for about 1-2% of the total number of coronary artery disease cases. In this age group, chest pain is easily mistaken as a symptom of respiratory disease, digestive disease or muscle tension, so it is often missed if not examined by the right specialist.
Mr. Chen (Chinese nationality) has had a dull pain in his left chest since half a month ago, sometimes it throbs for a few seconds and then goes away. The frequency of pain increased, along with symptoms of fatigue, difficulty breathing, and shortness of breath. He went to Tam Anh General Hospital in Ho Chi Minh City for examination. Dr. Khang said that in people over 55 years old, chest pain often suggests coronary artery disease or cardiovascular disease. For people under 40 years old like Mr. Chen, this symptom is easy to ignore, patients often go to see other specialists such as respiratory or gastroenterology….
Coronary angiography results confirmed that all three main arteries feeding Mr. Chen’s heart were complexly blocked. The anterior interventricular branch is semi-obstructed, diffusely narrowed in many segments, the circumflex artery and right coronary artery are narrowed more than 90%. This condition causes the heart muscle to not be adequately perfused with blood, reducing its contractile function, with a high risk of leading to myocardial infarction, heart failure or sudden death.
Assessing the complex injury and high risk of intervention, the team decided to undergo bypass surgery for the patient instead of placing a stent. To reduce the risk, Mr. Chen was operated on without using extracorporeal circulation (Off‐Pump).
The doctor performed bypass surgery to revascularize the patient’s coronary artery system. Image: Thanh Luan
Within 5 hours, the surgeon dissected two internal mammary arteries to create three bridges to connect the left coronary branches, and took the saphenous vein as a bridge to revascularize the right coronary artery. Immediately after reperfusion, the myocardium recovered and contracted well, and the heart continued to beat naturally throughout the surgery. Compared with traditional surgical methods that temporarily stop the heart, coronary artery bypass surgery without extracorporeal circulation brings many advantages such as faster recovery, reduced risk of post-operative complications such as infection, pneumonia, blood loss, arrhythmia, stroke…
Mr. Chen left the recovery room after one day, walked and ate normally, and was discharged from the hospital 5 days later.
Dr. Khang said that many young people often think that coronary artery disease only occurs in older people, so they are subjective and do not think about cardiovascular disease when they have symptoms. This makes the disease rarely detected early, treatment effectiveness is not high and can lead to dangerous complications.
Prevent coronary heart disease by stopping smoking, avoiding passive smoking, exercising regularly, avoiding stress, losing weight if overweight or obese, having a heart-healthy diet, and treating underlying diseases well. When symptoms suggestive of heart disease appear such as left chest pain, fatigue with exertion, shortness of breath, sweating… the patient should see a doctor immediately.