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Cardiac Bypass Surgery

How Is The Procedure Performed?

Tuesday, March 20, 2012 - 17:36

Just before the surgery, you will be given a mild sedative. If you are a man, your chest will be shaved. If blood vessels are to be taken from your legs, they will be shaved too. You will then be moved to the operating room.

The operating room can be intimidating and feel cold at first, but the sedative should help you to feel calmer. If you are extremely uncomfortable, talk to the anesthesiologist. The anesthesiologist will start an intravenous line (IV) and give you more sedation. Small patches will be put on your chest for monitoring your heart, and the anesthesiologist will ask you to breathe into a mask. At this point the anesthesia starts, and you will be asleep for the procedure.

After you are asleep, the anesthesiologist will insert more IVs including special IVs to monitor the pressures in your heart. You will be washed with antiseptics and draped with sterile plastic covers and towels. The surgical team will then:

  • Make an incision down the center of the breastbone
  • Connect the heart to a heart-lung machine that will take over its work during surgery
  • Remove a blood vessel or blood vessels from elsewhere in the body, either an artery from the chest (the internal mammary artery from the front of the chest), from the arm (the radial artery), or veins from the leg that will be used in the bypass
  • Attach the new blood vessels to the coronary arteries to bypass the blockages in the arteries

The usual time for surgery is between 3 and 5 hours, depending on the number of bypasses and the complexity of the surgery.

Nice To Know:

Are there any new developments in coronary bypass surgery?

Recent advances in stabilizing the heart as it beats allows surgeons to do coronary bypass surgery without the use of cardiopulmonary bypass. This is known as beating heart surgery. There are several stabilizers available that immobilize the heart at the point of the graft. This allows the surgeon to do the grafting on immobilized tissue while the rest of the heart beats. Advantages of beating heart surgery include the decrease in the inflammatory response, decreased bleeding, and improved organ function. Disadvantages include the difficulty in accessing areas of the heart that continue to beat.


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