CardioSpecialists Group, Ltd.
About Your Coronary Artery Bypass Graft
Also called: Coronary Bypass Surgery, Heart Bypass Surgery, Coronary Artery Bypass Grafting, CABG, Coronary Artery Bypass
What Is a Coronary Artery Bypass Graft?
A Coronary Artery Bypass Graft is not a test, it is a procedure. Angioplasty Coronary artery bypass is only used in about 10% of patients with coronary artery disease. This occurs when or more of the main arteries which supply the heart with blood become blocked. To prevent a heart attack, a coronary artery bypass must be done to provide a way for blood to reach the heart. This procedure creates a bridge in the coronary artery by attaching a healthy blood vessel to the blocked artery. The healthy blood vessel is taken from another part of your body, usually in the leg, arm, or chest.
The blood travels through aorta until it comes to the attached bridge. Then, the blood is rerouted through the new blood vessel, around the blockage in the cardiac artery and back to the coronary artery on the other side of the obstacle. This type of surgery is one of the most commonly performed and a trusted procedure for those patients who require it.
How Is the Procedure Performed?
You will be given medications before the procedure to ease the procedure for the surgeon. The area from which the healthy blood vessel will be taken is shaved, cleaned, and an anesthetic applied. You will be administered sedatives through an IV until you are asleep. During the procedure, a special gas (general anesthesia) to keep you asleep will constantly be given by the anesthesiologist.
A tube called a Swan-Ganz catheter is put into the main vein in your neck with a needle prick. This catheter is fed to the artery which goes from the heart to the lungs. It acts to both measure the heart and lung pressure and to give any medications at the site, if needed. Another tube is inserted into your throat to keep your airway open, and a third is used to monitor urine output.
A cut is made in your chest, through the breastbone (sternum). The two halves of the rib cage are pushed apart with a retractor to open the area for the surgeon to work. You will be attached to an artificial heart-lung machine to pump your blood during the main part of the procedure when your heart is stopped. This can last between 30 and 90 minutes.
After your blood is flowing through the heart lung machine, the surgeon removes the healthy blood vessel from a tiny cut at the site. This will usually be in your upper thigh or arm. Your heart is stopped, and the surgeon attaches one end of the healthy blood vessel to the aorta and the other end on the other side of the blocked coronary artery. Blood is sent flowing through the new vessel, and once the doctor is certain that the graft is secure, your heart will be restarted and the heart-lung machine is removed. With your heart pumping blood on its own, the surgeon closes your rib cage, tying the halves together with wire, then closes the other incisions made. You will be taken to the cardiac surgery intensive care unit after the four to five hour procedure is complete.
After the Procedure
Expect to stay in the hospital for up to five days after your procedure. For the first 12 to 24 hours after the procedure, you will be closely monitored in the cardiac surgery intensive care unit. Your family members will be permitted to see you until you are released. When you go home some side effects are normal, these include: constipation, difficulty sleeping, swelling of the graft site, loss of appetite, mood swings, muscle soreness, and poor concentration. These could last for four to six weeks after the procedure. If you have any other symptoms, discuss them with your doctor.
When your doctor feels that you have recovered sufficiently, you will be encouraged to enroll in a doctor-supervised cardiac rehabilitation program. These programs are designed to teach you how to adapt your lifestyle to being more heart healthy.
Is It Safe?
Coronary artery bypass is one of the most frequent surgeries performed, but there is a slight chance of risk of heart damage (5%) or death (less than 2%) from the procedure. Some factors will increase your chance of complications. Discuss any concerns and questions you have with your doctor before the surgery.