What is Coronary Artery Bypass Surgery and Why Do I Need it? -

What is Coronary Artery Bypass and Why Do I Need It?
To understand why you need surgery and what the surgeon will be doing, it is helpful to understand how your heart works and what happens when heart arteries become clogged.

The Healthy Heart
The heart is about the size of both of your fists put together. It constantly pumps blood through your body. Because it never stops working, the heart muscle must have lots of oxygen-rich blood. Your heart gets this blood from your coronary arteries.

You have two coronary arteries: the right coronary artery and the left coronary artery. The left divides again into the left anterior descending artery and the circumflex artery. These branches continue to divide into smaller arteries, supplying every portion of the heart muscle with oxygen-rich blood.

In the healthy heart, blood flows through these arteries smoothly, providing the heart muscle with all the oxygen and nutrients it needs. Even during activity, when the heart needs more oxygen, healthy arteries are able to deliver it.

Blocked Arteries
If fat and calcium collect in the artery walls (this is called "plaque"), blood flow will decrease because the arteries get narrower. If an artery becomes too narrow, the heart muscle may not be able to get the oxygen it needs. This can result in a "heart attack".

Coronary Artery Bypass Surgery
You are having coronary artery bypass surgery because one or more of your coronary arteries is narrowed or blocked. In this surgery, another blood vessel ("graft") is used to go around, or bypass, the block in your artery, providing your heart muscle with new blood flow.

These blood vessel grafts are usually taken from the veins in your legs (saphenous veins), one of the arteries in your chest wall (usually the internal mammary artery) or from an artery in your arm. If leg grafts are used, an incision will be made down the inside of your leg (calf, thigh, or both) to obtain the veins. The removal of these blood vessels does not usually affect blood flow. Depending on a variety of factors, our surgical team may use a minimally invasive technique to remove this vein.

During the surgery, an incision is made down the middle of your breastbone (sternum), to expose the heart. Then your heart is cooled and stopped. While your heart is stopped, the normal work of the heart and lungs is done by the heart-lung bypass machine.

The blocks in your arteries are then "bypassed" using the removed vessels as new pathways for blood flow. After the surgeon is sure the new vessels are working, your heart is allowed to restart and the heart-lung bypass machine removed. Then, your chest will be closed.

Some operations are performed without the use of the heart-lung bypass machine. Medical conditions dictate the use of the heart-lung bypass machine and are made at the surgeon’s discretion.

The surgery usually takes about three to five hours.

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