Heart bypass surgery
Alternative names:
bypass surgery - heart; CABG; coronary artery bypass graft
Definition:
Heart bypass surgery (coronary artery bypass graft) is done to relieve blockages of the blood vessels of the heart muscle. Vein grafts are connected above and below the blockage to allow adequate blood flow to the heart muscle.
Description:
The heart muscle (myocardium) works constantly and requires oxygen-rich blood, delivered through small arteries (called the coronary arteries). When fats and cholesterols accumulate inside the small coronary arteries (atherosclerosis), there is less room for blood to flow. When the heart muscle cannot receive adequate blood supply through the arteries, heart pain (angina) or heart attack (myocardial infarction) occurs. Coronary bypass surgery is used to "bypass" the blockage and restore adequate blood flow to the heart muscle.
Coronary bypass surgery is an open heart surgery (the chest is opened, but not the heart itself). It is done through an opening through the breast bone (sternum). While one surgeon is working on the chest, another surgeon works on taking a length of vein (for the bypass) through a long incision along the inside of the lower leg. The vein is sewn in above and below the blockage in the coronary artery.
Although the heart itself is not "opened", the heart-lung bypass machine is used to re-route the blood from the heart while the surgery is being done to provide adequate circulation to the brain and other vital organs.
Rarely, a device called a stent may be placed. This is a small tube that is placed within the coronary artery to keep the grafted vessel open. One type, called an intraluminal coronary artery stent, is made of self-expanding, stainless steel mesh.
Indications:
Coronary artery bypass is recommended when one or more coronary arteries are seriously blocked and blood supply to the heart muscle is insufficient. Several tests will be done to identify the cause of the chest pain (angina), such as blood tests and X-ray studies (angiograms).
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