Coronary Bypass Surgery
Your doctor has recommended coronary artery bypass surgery to treat coronary artery disease (CAD). When you have CAD, one or more of the arteries that supply your heart with blood and oxygen become narrowed or blocked with fatty deposits called plaque.
If CAD is not treated, it can lead to a heart attack. Coronary artery bypass surgery is often used to treat blockage in the coronary arteries. In this surgery, a blood vessel from another part of the body is used to bypass a blocked artery. The transplanted vein or artery carries blood to the heart muscle beyond the blocked area.
Bypass surgery is not a cure for coronary artery disease, but it does improve blood flow to the heart.
CORONARY ARTERY DISEASE
In order to pump blood to all parts of your body, your heart needs a steady supply of blood and oxygen. It gets its blood supply from the coronary arteries, the blood vessels that lie on the surface of your heart.
Arteries are normally elastic, allowing blood to flow easily through them. As we age our arteries harden and lose some of their ability to expand. Fatty deposits called plaque can build up inside the artery walls. Plaque begins to build up when the normally smooth artery lining is damaged. The damage may be caused by smoking, high blood pressure, and other factors. As plaque builds up, the insides of the arteries narrow and it becomes harder for blood to get through.
It is also possible for plaque to rupture or erode. If this happens, blood clots develop. Blood clots can completely block an artery and result in a heart attack.
YOUR TREATMENT
In some cases, blockages can be treated with nonsurgical procedures such as angioplasty and stenting. However, it is not always possible to treat blocked arteries in this way. Based on the size, number, and location of your blockages, your doctor has determined that bypass surgery is the best option for treating your coronary artery disease. You will be told how to prepare for your surgery. Be sure to share any concerns you may have with your doctor and the nurses.
BEFORE YOUR SURGERY
You may have blood and urine tests to check for any possible problems that may interfere with your surgery. You may meet with your health care professionals to talk about the anesthesia. Report any problems you have had with anesthesia and any medication allergies you may have.
BEFORE YOU GO TO THE HOSPITAL
• Give a list of your medications to your health care professionals well before surgery. Include any nonprescription items, such as allergy tablets, vitamins, and herbal remedies.Ask how far in advance you should stop taking your medications.
Tell your health care professionals if you are taking aspirin or blood thinners. You may need to stop taking these medications several days before surgery.
BEFORE YOU CHECK IN
JUST BEFORE YOUR SURGERY
HOW BYPASS SURGERY IS DONE
In open heart surgery, the chest is opened and the breastbone is surgically divided so your doctor can do surgery on your heart. During surgery your heart may not be beating, but blood continues to move through your body by way of a 11eart lung machine.As blood moves through the machine, it is cleaned, given a fresh supply of oxygen, and is then pumped back to your body.
In some cases, open heart surgery is done while the heart is beating. Your doctor may refer to this as offpump surgery, which means that a heart-lung machine is not needed. The heart continues to pump blood while the surgery is being performed. Your doctor will determine the best way to perform your surgery.
In coronary artery bypass surgery, a blood vessel from another part of the body is used to bypass the blocked part of the coronary artery. The saphenous vein from the leg, the radial artery from the forearm or tile internal mammary artery is used.
When the saphenous vein or radial artery is used, it is removed from the leg or forearm. One end of the vein or artery is grafted or sewn onto the aorta.The other end of tile vein or artery is sewn onto the coronary artery below the blocked area. When an artery from the chest is used, one end usually stays connected to the aorta and the other end is sewn to the coronary artery below the blockage.
The transplanted vein or artery, known as a graft, carries blood to the heart muscle beyond the blockage. If there is more than one blocked area, one blood vessel is used to bypass two or more areas of blockage.
AFTER SURGERY
Directly after surgery, you will be moved to the intensive care unit (ICU) to begin your recovery. You will have several tubes attached to your body which will soon be removed. Wilen you are ready, you will leave the ICU and continue your recovery in another part of the hospital.
A short time after surgery, the nurses will help you get out of bed and walk short distances. You will be asked to cough and do deep breathing exercises to help bring up secretions from your lungs. You will begin to eat and drink. You may notice a loss of appetite but as you recover, your appetite will return.
GOING HOME
How long you stay in the hospital depends on your overall health and how well you are doing. Your doctor will tell you when you can go home. Once you are home, you will be able to take a more active role in your recovery. You will be given guidelines for your home recovery. Talk to the hospital staff if you have questions.