A5 Bypass Free

[William Dupere]

Coronaryartery bypass surgery creates a new path for blood to flow to the heart. A healthy blood vessel from another part of the body is used to redirect blood around a blocked area of an artery. Usually the blood vessel is taken from an artery in the chest, called the internal mammary artery. Sometimes it's taken from a leg vein, called the saphenus vein.

Coronary artery bypass surgery creates a new path for blood to flow around a blocked or partially blocked artery in the heart. The surgery involves taking a healthy blood vessel from the chest or leg area. The vessel is connected below the blocked heart artery. The new pathway improves blood flow to the heart muscle.

Coronary artery bypass surgery doesn't cure the heart disease that caused a blockage, such as atherosclerosis or coronary artery disease. But it can reduce symptoms such as chest pain and shortness of breath. The surgery, commonly called CABG, may reduce the risk of heart disease-related death.

Coronary artery bypass surgery is done to restore blood flow around a blocked heart artery. The surgery may be done as an emergency treatment for a heart attack, if other immediate treatments aren't working.

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Your specific risk of complications after coronary artery bypass surgery also depends on your overall health before surgery. Having the following medical conditions increases the risk of complications:

Medicines to control bleeding and blood pressure and to prevent infection are typically given before surgery to reduce the risk of complications. If you have diabetes, you may get medicine to control blood sugar during surgery.

If coronary artery bypass surgery is a scheduled procedure, you are usually admitted to the hospital the morning of the surgery. You have many heart tests and blood tests the days and hours before surgery.

Coronary artery bypass surgery is major surgery that's done in a hospital. Doctors trained in heart surgery, called cardiovascular surgeons, do the surgery. Heart doctors, called cardiologists, and a team of other providers help care for you.

A surgeon typically makes a long cut down the center of the chest along the breastbone. The surgeon spreads open the rib cage to show the heart. After the chest is opened, the heart is temporarily stopped with medicine. The heart-lung machine is turned on.

The surgeon removes a section of healthy blood vessel, often from inside the chest wall or from the lower leg. This piece of healthy tissue is called a graft. The surgeon attaches the ends of the graft below the blocked heart artery. This creates a new pathway for blood to flow around a blockage. More than one graft may be used during coronary artery bypass surgery.

After the surgery is done, the health care providers restore your heartbeat in the operating room and stop the heart-lung machine. The surgeon uses wire to close the chest bone. The wire stays in your body after the bone heals.

After coronary artery bypass surgery, a team of health care providers checks on you and makes sure you are as comfortable as possible. You may feel sore and confused when you wake up. You can usually expect the following:

It usually takes about 6 to 12 weeks to recover after coronary artery bypass surgery. With your provider's OK, you can usually drive, return to work or the gym, and resume sexual activity after 4 to 6 weeks. But everyone recovers differently. Ask your health care provider for guidance.

After recovering from coronary artery bypass surgery, most people feel better. Some people remain symptom-free for many years. But the graft or other arteries may become clogged in the future. If this happens, you might need another surgery or procedure.

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Coronary artery bypass graft surgery (CABG) is a procedure used to treat coronary artery disease. Coronary artery disease (CAD) is the narrowing of the coronary arteries. These are the blood vessels that supply oxygen and nutrients to the heart muscle. CAD is caused by a build-up of fatty material within the walls of the arteries. This buildup narrows the inside of the arteries, limiting the supply of oxygen-rich blood to the heart muscle.

One way to treat the blocked or narrowed arteries is to bypass the blocked portion of the coronary artery with a piece of a healthy blood vessel from elsewhere in your body. Blood vessels, or grafts, used for the bypass procedure may be pieces of a vein from your leg or an artery in your chest. An artery from your wrist may also be used. Your healthcare provider attaches 1 end of the graft above the blockage and the other end below the blockage. Blood bypasses the blockage by going through the new graft to reach the heart muscle. This is called coronary artery bypass surgery.

Traditionally, to bypass the blocked coronary artery, your provider makes a large cut (incision) in the chest and briefly stops the heart. To open the chest, your provider cuts the breastbone (sternum) in half lengthwise and spreads it apart. Once the heart is exposed, your provider inserts tubes into the heart. This lets the blood be pumped through the body by a heart-lung bypass machine. The bypass machine is needed to pump blood while the heart is stopped.

The traditional open heart procedure is still commonly done. In many cases it may be preferred. But less invasive methods have been developed to bypass blocked coronary arteries. Off-pump procedures, in which the heart does not have to be stopped, were developed in the 1990's. Other minimally invasive procedures, such as keyhole surgery (done through very small incisions) and robotic procedures (done with the aid of a moving mechanical device), may be used.

Coronary artery bypass graft surgery (CABG) is done to treat a blockage or narrowing of 1 or more of the coronary arteries. It can restore the blood supply to your heart muscle when nonsurgical procedures are not a choice.

Along with a review of your health history, your provider may do a complete physical exam to make sure you are in otherwise good health before having the procedure. You may need blood tests or other diagnostic tests.

Tell your provider if you have a history of bleeding disorders or if you are taking any blood-thinning medicines, aspirin, or other medicines that affect blood clotting. You may be told to stop some of these medicines before the procedure. Ask which medicines to take, and which to stop, and when you should stop taking them.

A healthcare professional will insert an IV (intravenous) line in your arm or hand. Other catheters will be put in your neck and wrist to monitor your heart and blood pressure, as well as to take blood samples.

The anesthesiologist will continuously keep track of your heart rate, blood pressure, breathing, and blood oxygen level during the surgery. Once you are sedated (put into a deep sleep), a breathing tube will be put into your throat and you will be connected to a ventilator, which will breathe for you during the surgery.

Once all the tubes and monitors are in place, your provider will make cuts in 1 or both of your legs or 1 of your wrists. This is to access the blood vessel(s) to be used for the grafts. They will remove the vessel(s) and close those incision(s).

To sew the grafts onto the very small coronary arteries, your healthcare provider will need to stop your heart temporarily. Tubes will be put into the heart so that your blood can be pumped through your body by a heart-lung bypass machine.

When the heart has been stopped, the provider will do the bypass graft procedure by sewing one end of a section of vein over a tiny opening made in the aorta, and the other end over a tiny opening made in the coronary artery just below the blockage. If your provider uses the internal mammary artery inside your chest as a bypass graft, the lower end of the artery will be cut from inside the chest and sewn over an opening made in the coronary artery below the blockage.

You may need more than 1 bypass graft done, depending on how many blockages you have and where they are located. After all the grafts have been completed, the provider will closely check them as blood runs through them to make sure they are working.

Once the bypass grafts have been checked, the provider will let the blood circulating through the bypass machine back into your heart and they will remove the tubes to the machine. Your heart may restart on its own, or a mild electric shock may be used to restart it.

The provider will do the bypass graft procedure by sewing one end of a section of vein over a tiny opening made in the aorta, and the other end over a tiny opening made in the coronary artery just below the blockage.

After the surgery, you may be taken to the recovery room and then the intensive care unit (ICU) to be closely monitored. Machines will constantly display your electrocardiogram tracing, blood pressure, other pressure readings, breathing rate, and your oxygen level. Coronary artery bypass surgery (CABG) requires a hospital stay of at least several days.

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