(CNN) -- The type of surgery Boris Yeltsin underwent Tuesday
is becoming common in the United States but is rare in the
Russian president's homeland. The number of heart bypass
operations performed in the United States each day -- about
1,000 -- is about 10 times the number performed in Russia in
an entire year.
For a motorist, a bypass is a road that avoids a congested
area. A surgeon performing a heart bypass operation carries
out a similar function. Blood vessels taken from other parts
of the body are sewn around blocked arteries. In effect,
blood is given a way to bypass the problem. (226K/22 sec. QuickTime movie)
The bypass restores healthy circulation to the heart so it
can beat stronger and more safely.
While non-surgical treatment is also possible, heart surgeon
Dr. John Parker Gott of Atlanta told CNN bypasses "show a
great advantage over other therapies" in cases where more
than one bypass is necessary.
Heart is stopped ...
While the heart is being repaired, it must be stopped. A
heart-lung machine keeps the patient alive for the portion of
the operation -- usually one to three hours -- needed to sew
in the bypasses.
Heart surgeon Alan Wolfe on bypass surgery:
||2 reasons for bypass surgery
(13 sec./289K AIFF or WAV sound)
||The most devastating part
(9 sec./218K AIFF or WAV sound)
Being able to operate on a heart that isn't moving has
"allowed us to operate on increasingly smaller (blood)
vessels," said Dr. Alan Wolfe, an Atlanta heart surgeon.
... and restarted
Electric paddles are usually needed to re-start the
heartbeat. Patients leave the operating room in critical
condition, but most are able to sit up and even get out of
bed by the next day.
The length of recovery depends on "the amount of time spent
on the heart-lung machine," Dr. Gott said. The fewer number
of bypasses, the less time on the heart-lung machine and the
quicker the recovery, he said.
For the first 24 hours after surgery, doctors worry about
leaks from the bypass. Internal bleeding can be a dangerous
There's also a risk that a heart, weakened by the stress of
surgery, might suddenly quit pumping. Infection, pneumonia
and stroke are additional worries, Wolfe said.
Quick recovery possible
The odds, however, are solidly on the patient's side. The
survival rate for a heart bypass operation is about
95 percent. For many patients what follows next --
rehabilitation -- can be more uncertain.
Resuming normal activities, even something as simple as
walking, is a slow but steady process, depending on what the
patient can tolerate, says Mary Beth Bova, director of
cardio-vascular services at St. Joseph's Hospital in
Atlanta. (252K/11 sec. AIFF or WAV sound)
Three days after his surgery, bypass patient Paul Dixon
remains hospitalized, saying he tires easily but feels little
pain. Even though Dixon is drained and pale for the moment,
his doctors and nurses expect rapid progress each day.
"My recovery was quite phenomenal," said Robert Kern, 60, who
left the hospital four days after quadruple bypass surgery
and began working from home two weeks later.
Barring complications, many heart bypass patients in the
United States go home from the hospital in about five days
or less. Some can return to office jobs, part-time at least,
about a month after surgery.
Exercise, exercise, exercise
Simple exercises at the hospital start almost immediately
after the operation. Within a couple of weeks, formal
cardiac rehabilitation begins with regular supervised
workouts designed to build endurance and strength gradually.
In addition to continuing regular exercise, bypass patients
are urged to reform their diet and quit smoking. They may
also take cholesterol-lowering drugs to slow the return of
Based on his own experiences, Kern says, Yeltsin "should be
able to do some work within a few weeks."
Correspondents Dan Rutz and Andrew Holtz contributed to this