The First Time I … Performed a Triple Bypass

Dr. Harold Howe
Cardiothoracic Surgeon, Hawthorne Cardiothoracic and Vascular Surgeons at Presbyterian Hospital

Dr. Harold Howe

Chris Edwards

During residency, you do bits and pieces of operations, typically more as time goes on, but there's always an attending physician available. You do hundreds of operations like that before finally leaving the nest and practicing on your own.

The first bypass I did as the senior physician was twenty-one years ago, over a weekend, when I was the doctor on call. It was a lady with nearly 95 percent blockage in at least one or two of her arteries. With that type of blockage, you really don't have the luxury to wait to operate; there's no way to tell how long it'll take for a clot to form on the blockage and cause a heart attack. It could be a matter of weeks or just twenty-four hours.

We connected her to a heart-lung machine to establish cardiopulmonary bypass, and then drained the heart of its blood so we could work on the arteries for a period of time, probably between three and four hours. What we do in bypass is use a conduit to reroute blood through the heart. We'll use mammary arteries, or even take veins from the patient's legs. Luckily, there were no wrinkles in this case; she was in the hospital, recovering, for about five days after the surgery, and we were able to send her home after that.

It hit me only as an afterthought that I had done the whole procedure on my own. Of the hundreds of cases I'd helped with before then, and the hundreds I've done since, it went just like those, but I do remember that increased sense of responsibility. It's a scary feeling, because the stakes in heart surgery are extremely high. The life or death of that patient is your sole responsibility. —As told to Annie Monjar

5 Ways to Avoid Seeing Dr. Howe

  1. Quit, already. Patch it, chew it, do whatever you have to, but know that those ten-minute smoke breaks in the parking lot increase your blood pressure and reduce your good cholesterol, making you an easy target for heart disease.
  2. Take the stairs. Five days a week for thirty minutes. Fine, you don't have to climb the stairs, but make sure you're breaking a sweat for at least that amount of time. It keeps your heart strong and fends off obesity — a major factor in determining your risk for heart disease.
  3. Chill out. reducing daily stress can take the edge off high blood pressure, so find a way to mellow every day, whether it's taking quiet time on the couch or joining a yoga class.
  4. Read your risk. Howe suggests being proactive and having your primary-care physician draw your lipid panel, a test that measures your cholesterol and gives you an idea of what kind of risk you're at. If needed, you and your doc can decide how to manage your lipid levels.
  5. Shelve the Morton's. It's not just hype: sodium — often hidden in everything from soups to diet sodas—wreaks havoc on your cholesterol. So go for reduced-sodium options at the grocery store, and trade your table salt for thyme or other flavorful herbs.
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