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Heart Bypass Surgery

Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to reach your heart when one or more of the coronary arteries become obstructed. The surgery involves removing a healthy blood vessel from another part of the body and grafting it onto the heart to circumvent the blocked artery.

During traditional heart bypass surgery, a surgeon makes an incision (about 6 to 8 inches) down the center of your sternum (breastbone) to get direct access to your heart. You are connected to a heart-lung bypass machine, which allows for circulation of blood throughout your body during surgery. The heart is stopped and the surgeon then performs the bypass procedure described above. The heart is generally stopped for about 30-90 minutes of the 4-5 hour surgery.

After surgery, the surgeon closes the breastbone with special sternal wires and the chest with special internal or traditional external stitches.

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.

Different types of graft used include the following:

  1. Internal mammary arteries (also called thoracic arteries) are the most common bypass grafts used, as they have been shown to have the best long-term results. 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.
  2. Saphenous 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.
  3. Radial arteries are two arteries in the lower part of the arm, the ulnar and radial arteries. Most people receive adequate blood flow to their hand 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.
  4. The gastroepiploic artery to the stomach and the inferior epigastric artery to the abdominal wall are less commonly used for grafting.

It is common for three or four coronary arteries to be bypassed during surgery. A coronary artery bypass can be performed with traditional surgery or with minimally invasive surgery. Your surgeon will review your diagnostic tests prior to your surgery to see if you are a candidate for minimally invasive bypass surgery.

Heart bypass surgery is one of the most commonly performed surgeries in the United States and Caribbean.


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