Also known as a heart bypass or bypass surgery, a coronary artery bypass is a surgical procedure that uses harvested veins or arteries from elsewhere in the body to repair damage to the coronary arteries. The harvested arteries circumvent or bypass narrow areas of the coronary arteries and restore a normal flow of blood through the heart. First performed in 1960, this type of surgery has prevented the deaths of a number of people suffering with coronary artery disease, allowing them to enjoy many more years with family and friends.
This type of surgical procedure has proven extremely helpful when arteriosclerosis is present. A thickening of the arterial walls, as well as an increasing amount of rigidity in the walls themselves, distinguishes this condition. The result is that blood cannot pass through the arteries efficiently, effectively increasing stress on the heart and paving the way for coronary failure. By grafting in new arteries, the blood flow is restored, the heart does not have to work as hard to pump blood, and the chances of a heart attack are greatly decreased.
The actual process of a coronary artery bypass may involve one or more actual grafts along one or more arteries in order to circumvent the damage. The number of grafts employed will depend on the number of bypasses that are required to restore proper blood flow to the heart. For this reason, a coronary artery bypass may be identified as single bypass surgery, a double or triple bypass, or even quadruple bypass surgery.
In order to perform a coronary artery bypass, the general health of the individual is assessed. If the patient is deemed stable enough for the operation, the surgeon schedules the procedure. Using anesthesia to render the patient unconscious, an endotracheal tube is inserted into the oral cavity and routed down the throat. This makes it possible to make sure the patient receives a proper supply of oxygen during the course of the bypass surgery.
In most approaches, the surgeon will then open the chest and examine the heart. Assuming no new evidence is obtained that would discourage the continuance of the surgery, veins or arteries from other parts of the body are harvested at this time. Medication is administered to prevent blood from clotting during the harvesting process.
Before the grafts can be put into position, the heart must be stopped. This process is known as caredioplegia. Just prior to stopping the beating of the heart, the patient is placed on a pump that will perform the function of the heart during the procedure. If the patient is stable at this point, the grafting can begin.
Once the grafts are put into position and sewn on to the arteries so they can effectively redirect the flow of blood around the blockages, they are tested to make sure they are secure. Once the surgeon is satisfied that the grafts will function properly, the heart is restarted. Care is taken to make sure the heart is pumping normally before the sternum is wired and the chest is closed.
After a coronary artery bypass is complete, the patient is usually kept in an intensive or critical care unit for at least twenty-four hours. If the patient does well, he or she is then moved into a cardiac surgery area for several more days of observation. Assuming there are no complications and the patient is recovering on schedule, he or she is allowed to leave the hospital after four to five days, with strict instructions that must be followed for the remainder of the recovery period.
Over the years, several innovations in coronary artery bypass surgery have been developed. There are now processes that allow the bypass to take place without stopping the heart, Newer techniques also make it possible to use less invasive methods, especially when a single bypass is required. This has meant patients are able to recover from the operation in less time, and also run less risk of complications. As modern medicine continues to advance, additional enhancements to this procedure are sure to be developed.
