Heart Disease and Heart Bypass Surgery

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Heart bypass surgery can be used to treat heart disease when your
coronary arteries are blocked. Your doctor may treat the problem by
giving the blood a new pathway to the heart.

During coronary artery bypass graft surgery (also called CABG, or
"cabbage") a blood vessel is removed or redirected from one area of
the body and placed around the area or areas of narrowing to "bypass"
the blockages and restore blood flow to the heart muscle. This vessel
is called a graft.

These substitute blood vessels can come from your chest, legs, or
arms. They're safe to use because there are other pathways that take
blood to and from those tissues. The surgeon will decide which graft
(s) to use depending on the location of your blockage, the amount of
blockage and the size of your coronary arteries.

Heart bypass surgery is one of the most commonly performed surgeries
in the U.S.
Which Blood Vessels Are Used for Grafts in Heart Bypass Surgery?

There are several types of bypass grafts used for heart bypass
surgery. The surgeon decides which graft(s) to use, based on the
location of the blockage, the amount of blockage, and the size of the
patient's coronary arteries.

* Internal mammary arteries (also called thoracic arteries). These
are the most common bypass grafts used, as they have been shown to
have the best long-term results. In most cases, these arteries can be
kept intact at their origin since they have their own oxygen-rich
blood supply. During the procedure, the arteries are sewn to the
coronary artery below the site of blockage. This artery is located in
the chest and can be accessed through the primary incision for the
bypass surgery.
* Saphenous veins. These veins are removed from your leg, and then
sewn from your aorta to the coronary artery below the site of
blockage. Minimally invasive saphenous vein removal may be performed
and results in less scarring and a faster recovery.
* Radial artery. There are two arteries in the lower part of the
arm, the ulnar and radial arteries. Most people receive adequate blood
flow to their arm from the ulnar artery alone and will not have any
side effects if the radial artery is removed and used as a graft.
Careful preoperative and intraoperative tests determine if the radial
artery can be used. If you have certain conditions (such as Raynaud's,
carpal tunnel syndrome, or painful fingers in cold air) you may not be
a candidate for this type of bypass graft. The radial artery incision
is in your forearm, about 2 inches from your elbow and ending about 1
inch from your wrist. If you have this type of bypass, you will
probably be prescribed a medication called a calcium channel blocker
for about six months after surgery to help keep the radial artery
open. Some people report numbness in the wrist after surgery. However,
long-term sensory loss or numbness is uncommon.
* The gastroepiploic artery to the stomach and the inferior
epigastric artery to the abdominal wall are less commonly used for
grafting.


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