CORONARY ARTERY BYPASS GRAFT

BYPASS GRAFT SURGERY

In bypass surgery, heart surgeons detour a blockage
in an artery by grafting a part of another blood vessel
around it.

When an artery leading from the heart becomes

clogged with plaque material composed
of cholesterol and fats that form and harden inside
blood vessels the heart can't receive all of the
blood that it needs. That spells big trouble and can
lead to a heart attack.
So for people who have a serious blockage,
sometimes the only way to restore blood flow is to
create a new path for blood to follow. How?
Bypass surgery involves taking a piece of a healthy
blood vessel from elsewhere in the body and
grafting, or attaching, it to the damaged vessel. In
doing so, the blood flow is rerouted around the damaged part. This procedure is known as coronary artery
bypass surgery, or coronary artery bypass grafting (CABG, pronounced "cabbage").

Bypass Surgery: Before the Main Event

Before undergoing coronary artery bypass surgery, it's important to go over a few things with your doctor. Be
sure to talk to him about:
Any illnesses or symptoms even a cough or cold
Any fever
All medications that you take, both over-the-counter and prescription, particularly aspirin or other
medications that increase your bleeding risk
Quitting smoking if you're a smoker
You may be admitted to the hospital the night before the bypass surgery, or sometimes the morning of.

A Closer Look at Bypass Surgery

Once you're in the hospital and the doctor is ready to perform the bypass surgery, here's what happens, step-
by-step:
1. The area of skin to be cut will be washed with an antiseptic solution to get rid of germs, then shaved if
necessary.
2. You may have an electrocardiogram (EKG) to check your heart function before the surgery starts.
3. You'll be given an intravenous line (IV) and anesthesia to make you comfortable, ensure you don't feel
pain, and make you fall into a deep sleep for the surgery.
4. A tube connected to a respirator will be placed through your mouth and into your windpipe to help you
breathe during the surgery.
 5. Another tube will be placed inside your nose, which will run down your throat and into your stomach to
prevent air and fluids from building up in your stomach.
6. Medical personnel will also place a catheter (a thin tube) in your bladder to collect the urine that is
produced while you are in surgery.
7. You'll be given an anticoagulant or blood-thinning medication to prevent blood clots.
8. You may be hooked up to a heart-lung machine so that your surgeon can operate without your heart
beating during the surgery. The heart-lung machine assumes the role of your heart and pumps oxygen-
rich blood into your aorta for distribution throughout your body and then receives blood used by the
body from the venous system. Alternatively, off-pump bypass surgery may be performed, where the
heart continues beating during the procedure.
9. Your heart will be stopped and kept cool during the surgery, if a heart-lung machine is used.
10. The doctor will remove a piece of a vein or artery from somewhere else in the body often the leg, or
sometimes an artery from the chest. This is what is called a graft and will be used to channel flow past
the blockage.
11. One end of the graft is attached to the aorta, while the other end is stitched to an area on the other side
of the blockage. This allows blood to flow around the blockage and get to the heart safely.
12. The grafting process may be repeated several times if there are several blockages. The total time of the
operation may run from two to six hours, based on how many grafts need to be performed.

After the Surgery

You'll need to recover in the hospital for around a week, including a several-day stay in the intensive care unit.
You should be able to resume most of your normal activities about four to six weeks after the bypass surgery.

Once you go home again, it's important to make healthy lifestyle changes to prevent another blockage, and
the need for future bypass surgeries. Things that can help you get healthy and stay healthy after coronary
bypass surgery include:

Getting regular exercise, such as swimming or walking

Reducing fat and cholesterol in your diet
Participating in a cardiac rehabilitation program
Taking medications to lower cholesterol and prevent blood clots

Coronary artery bypass surgery doesn't undo the

damage that's been done to your heart by years of
unhealthy behaviors it simply finds a way to work
around it. But you can prevent more damage from being
done to your hearts arteries by making lifestyle changes
to keep blockages from affecting your heart health
again.