Heart & Cardiology/Discomforts Long After Bypass Surgery
QUESTION: I had quadruple bypass surgery nearly 2 years ago. Recovery is going extremely well. No chest pain or shortness of breath at all. I take long brisk walks everyday with no problems. Angina is totally gone since day one. One problem that is not going away is the chest discomfort in my muscles and nerves that are regenerating. Will I ever feel normal in the chest again, or is this the new normal for me? Thank you.
Unfortunately one of the drawbacks to conventional bypass surgery is the fact that the sternotomy is a big incision that involves basically sawing through bone, cartilage, nerves and other structures in order to gain access to the heart. Despite reapproximation of the sternum with the wires it is likely that some of this disruption remains and thus the continued associated pain and unfortunately there is no great treatment for this. This is actually relatively common and some are much more sensitive to it than others. In some cases there is a sharp pain that is worsened by pressing over certain points where the wires stick out. If this pain is limiting, easily reproducible, and thought to be related to the wires then removal and replacement of the wires can be considered.
Hope that was helpful,
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QUESTION: Thank you. That was very helpful. I was told that I do not have wires, but rather titanium plates that put my sternum back together. I do not have particularly sensitive points when pressing on my chest. Basically all around the pectoral muscles. Does this make a difference? When are titanium plates used rather than wires?
Sternal wires are what has classically been used for sternal closure and in a way has stood the test of time although not perfect given issues such as pain and in some cases stability which can limit healing. When plates were introduced there was some excitement as it was thought that this would provide more stability and improve healing. Although the short term results were excellent it was notes that the long term results in some cases were limited by the nature of the bone they were put in to, for example osteoporotic fragile bone where the screws could pull out, there were also increased problems in obese patients. Other problems were increased cost and operation time. For these reasons the plates have not had universal acceptance, having said that, in most cases they are fine and give good results.
Hope that was helpful,