From stress tests, angiograms and intravascular ultrasounds, your doctor is able to determine exactly how much of the heart structure needs repair. Some patients undergo double, triple or even quadruple bypasses, based on their specific needs. The number of grafts is not as important as is the bypass of the necessary blockages.
Doctors have found that grafts are most successful when attached to major coronary arteries rather than smaller arterial branches. Doctors have also found better results for bypass surgery when there are discrete, localized blockages rather than a buildup of plaque throughout an artery.
Will my heart be stopped?
In some cases, your blood circulation and breathing functions will be carried out totally by a heart-lung machine during surgery, also known as cardiopulmonary bypass. However, more coronary artery bypass surgeries are being done while the heart is still beating (called the off-pump technique). The beating heart approach may reduce the risk of neurologic injury, stroke and other complications associated with the heart-lung machine, and leads to a shorter hospital stay for patients.
Are there any transfusions involved? Should I bank my own blood?
Ordinarily, as with any serious heart surgery, blood transfusions are necessary during bypass surgery. The blood used for your surgery will be matched by type and Rh factor, and provided by a local blood bank.
You may be familiar with the case of Arthur Ashe, a well-known tennis player and activist who ultimately died of AIDS-related pneumonia. He acquired the AIDS virus from a transfusion received during a bypass procedure performed in 1983. Although this result was devastating, the national blood banks have advanced a great deal in the past 20 years, and blood is screened much more carefully for contamination, including AIDS and other infectious diseases.
Unless your surgery is scheduled in less than 72 hours, and if your doctor gives you permission, arrangements can be made for banking your own blood for surgery. You also may have family or friends with a compatible blood type donate blood for your surgery. The hospital, the Red Cross or blood bank can provide family members and friends with necessary information about blood donation for your surgery.
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