lf you have one or more blocked coronary arterias, your heart may not be getting enough blood and oxygen. lf a less invasiva procedure, like a balloon angioplasty, isn’t likely to open your arterias, your doctor may recommend bypass surgery. During bypass surgery, your doctor creates new pathways to route blood around blocked vessels.
A bypass is an open-heart surgery that requires general anesthesia. The full name for a bypass is a coronary artery bypass graft (or CABG, pronounced “cabbage”).
During bypass surgery your doctor takes (harvests) a piece of a healthy blood vessel-often from your chest, arm, or leg. This harvested vessel becomes the new path for blood flow around the blocked artery. Your doctor chooses the healthy vessel(s) based on the size and location of your blocked artery. Doctors usually choose from among these three options when taking vessels for bypass:
lt’s okay to remove pieces of these blood vessels for bypass because other vessels take over for them. Doctors more often choose arterias, rather than veins, for grafts. Veins sewn-or “grafted”–to heart arterias sometimes clog up again. Arterias are less likely to do so.
Traditional bypass surgery begins with an incision in your breastbone (sternum). With the traditional form of bypass surgery, your doctor needs to operate on a completely still heart. So you receive medications to stop your heart. A heart-lung machina then does the job of both the heart and the lungs:
Your doctor sews (grafts) one end of the healthy blood vessel just below the blocked artery. The other end of the healthy vessel is then sewn above the blocked artery. Blood flows through the new vessel, around the blocked area. This “detour” is the bypass graft. After bypass surgery, your blood flows more freely through your coronary arterias. So bypass surgery can lower your risk of heart attack.
A single bypass detours around one blocked artery. A double bypass detours around two blockages, and so on.
In addition to traditional bypass, sorne less invasiva kinds of bypass surgery now exist. Neither of these two types of surgery uses the heart-lung machina. Your doctor can tell you whether either of these less invasiva surgeries might work for you.
Minimally invasive bypass surgery-this requires a smaller incision near your ribs instead of the large incision through the breastbone.
Off-pump bypass surgery- a tool holds part of your heart still while the doctor operates. The rest of your heart beats as usual during this type of surgery.
Coronary bypass surgery is the most common type of vessel bypass. But blood vessels outside the heart-peripheral vessels- can also become blocked. This is called peripheral vascular disease (PVD), or peripheral artery disease. A bypass is sometimes needed to treat PVD.
The blood vessels in the leg are the peripheral vessels that most often get blocked. For bypass surgery on leg arterias, the healthy vessel is either another vessel from the leg or an artificial vessel. Peripheral artery bypass requires general anesthesia. However, because it is not a heart surgery, the heart-lung machina is not needed.
Usually you are told not to eat or drink anything for a number of hours before your surgery. You lie on an exam table and an intravenous (IV) line is put into your arm. The IV delivers fluids and medications during the surgery. You are then wheeled into the operating room, where you receive medication that makes you unconscious during the surgery. After surgery you may spend a few days in the intensiva care unit (ICU). That’s to make sure your heart is pumping normally and your chest is healing normally. You are usually out of the hospital within a week. You may have pain at the incision site for several weeks, but medication is provided for pain. At home, recovery often takes 4-6 weeks.
After your bypass surgery, your doctor may recommend cardiac rehabilitation. This involves a team of healthcare experts who work with you to help you recovar. To avoid future heart-related problems, the team:
Our knowledgeable and courteous staff will help set up a consultation for you, schedule surgical procedures, discuss your insurance, and answer any questions you may have.
