Coronary Artery Bypass Graft Surgery

What involves in the procedure?

Coronary artery bypass graft surgery is a surgical procedure that creates a new path for blood to bypass or get around narrowed or blocked artery of the heart. This allows blood going through the new path to reach the heart muscle. This procedure is required to treat people who have severe coronary artery disease.

Coronary artery bypass graft surgery involves taking a healthy piece of vein from leg or artery from chest or forearm (graft) and attaching it to the diseased coronary artery. The surgeon attaches one end of the graft above the narrowed area or blockage and the other end below the narrowed area or blockage.

During a traditional open heart procedure:

  • a breathing tube will be placed into patient’s lungs through their throat and the tube will be connected to a ventilator that supports breathing;

  • the surgeon will then make an incision in the chest, insert tubes into the heart so that the blood can be pumped through the body by a heart-lung bypass machine;

  • the heart-lung bypass machine will allow the surgeon to operate on a heart while the heart is stopped and does not have blood flowing through it.

As the result of the procedure, the new graft will allow blood to bypass the narrowed artery or blockage. Sometimes patients need more than one graft if few arteries are diseased.

This type of heart surgery takes about 3–6 hours.

What is a coronary artery disease?

Coronary artery disease is narrowing or blockage of the coronary arteries by a substance called plaque that builds up within the walls of the arteries. The narrowing or blockage of the arteries limits the supply of oxygen-rich blood to the heart muscle.

Why coronary artery disease is harmful?

The heart muscle supplied by the narrowed or blocked arteries does not get enough oxygen. The condition is called ischemica. People usually experience chest pain, so called angina, and are at risk of heart attack. Sometimes, however, people have ischemic episodes without knowing it, because they do not have chest pain at all. These people have a silent angina, and may have a heart attack with no prior warning. The risk of heart attack for the people with silent angina is the same as those with angina.

When a blood clot or thrombus forms on top of the plaque, the artery becomes completely blocked causing a heart attack. If the blood flow to the heart cannot be restored to the particular area of the heart affected, the tissue of the heart dies.

How the plaque develops?

The plaque can be caused by: