Bypass Surgery: Common Questions

Why do you need bypass surgery?

If you are suffering chest pain or other symptoms that may indicate a cardiovascular problem, your doctor will likely want you to undergo an angiogram (cardiac catheterization) to see if your coronary arteries are blocked by plaque. A blockage can cause a decrease in the supply of blood and oxygen to the heart, and over time can lead to debilitating chest pain or a heart attack.

If angioplasty proves unsuccessful, the position of the blockage is too difficult to access by angioplasty, or you have severe blockages in multiple major vessels, your doctor may recommend that you undergo coronary artery bypass graft (CABG) surgery.

Bypass surgery has been performed for nearly 40 years. Cardiovascular surgeons have received extensive training on bypass techniques. More than 500,000 bypass procedures are performed each year in the United States, making it the most frequently performed major surgery in the country.

What happens during bypass surgery?

Bypass surgery is a major operation that usually lasts between two and six hours. Pre-operative medications are often administered by mouth, muscular or subcutaneous injection, or intravenously. You will receive general anesthesia and be completely asleep.

During bypass surgery, the chest bone is separated, and the ribs are spread apart to allow visible and physical access to the heart. In most instances, blood circulation and breathing functions will be taken over by a heart-lung machine. The cardiac surgeon uses a piece of vein or artery to form a bypass to enable blood to go around the blockage. Several blockages can be bypassed during surgery.

What is a graft?

A graft is a blood vessel that has been created to bypass a blocked artery. It is usually taken from the internal mammary artery in the chest, the saphenous veins from the leg, or in rare instances from the radial artery in the arm. The graft is attached above and below the area in the artery where there is a blockage, so that the blood can use the new, unblocked path to flow freely to the heart.

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