Coronary Bypass Surgery
Open Heart Surgery Handbook
Coronary artery bypass surgery is the most frequently performed heart operation today, largely because it is a time-tested and highly successful method of relieving chest pain and in certain cases, prolonging life expectancy by restoring blood and oxygen flow to the heart muscle
The heart muscle receives its blood and oxygen through the coronary arteries. Although there are many reasons why bypass surgery may be recommended, there is a common thread in all cases: surgery permits the construction of new blood vessels, which detour blood past the blockage. This allows improved oxygen delivery and blood flow to the heart muscle.
When arteries are blocked, the heart's demand for oxygen is greater than available supply. The results can range from angina to a heart attack. Cardiac catheterization and coronary angiography will determine the location and extent of the blockage in the coronary artery, as well as the pumping capacity of the cardiac muscle. Because all coronary arteries and abnormalities are unique, much like fingerprints, your physician will carefully review your case and evaluate the need for surgery. If your physician believes that surgery is indicated, he will discuss the catheterization findings in detail with you and your family, and help you with your decision.
Coronary artery bypass surgery implies that a bypass or detour of the blood circulation to your heart will be created by the usage of grafts that are “harvested” or taken from your own body. These grafts are commonly removed from your legs (saphenous veins), from inside your chest wall (the internal mammary arteries or internal thoracic arteries), and from your forearm (radial artery). On occasion, arteries from your abdomen or abdominal wall may be used.
These grafts will work as a new conduit for the blood and will optimize the circulation to your heart muscle and deliver more oxygen, thus suppressing the angina and protecting you to a great degree against the possibility of a heart attack.
In special circumstances, it may be possible to accomplish coronary bypass without a large opening of the chest. This new approach is knows as MIDCAB (Minimally Invasive Direct Coronary Artery Bypass Grafts). These techniques are increasing in popularity and provide the advantages of bypass surgery with minimal pain and a faster recovery.
Please note that the removal of arteries from the chest wall or forearm will not hinder blood flow through the chest or arm, and removal of veins from the legs will not impair your ability to walk or work.