What is Coronary Bypass Surgery?

Coronary bypass surgery is a major surgical procedure done to restore a healthy blood flow to muscles of the heart. There are three coronary arteries on the surface of the heart that provide nutrients and oxygen to the heart. If these arteries become lined with plaque, they can narrow or become blocked completely. This would reduce blood flow and oxygen to the heart and portions of the heart muscle may become damaged. The heart may lose the ability to efficiently pump blood to the rest of the body.

Plaque can build up along the inside walls of the coronary arteries of the heart. This disorder is known as coronary atherosclerosis or coronary artery disease. Patients with high levels of cholesterol in the blood, especially the low density lipoproteins (LDL), are at the most risk of developing atherosclerosis.

Patients with atherosclerosis may not have any symptoms, or they may suffer from a range of conditions from angina to heart attack. Symptoms of angina are tightness and pain in the chest. A physician may choose to treat mild angina symptoms with medication and rest.

If the plaque build up in the coronary arteries is severe, pieces of plaque may break away from the wall and block the artery completely. If the artery becomes blocked, the oxygen supply to the heart is cut off and the patient may suffer a heart attack. Patients with one or more blocked arteries may qualify for coronary bypass surgery.

In order to diagnose coronary artery disease, the physician may order chest X-rays and an electrocardiogram (ECG). The ECG measures electrical impulses in the heart and may help determine where the blockages in the arteries are located. Another procedure, known as angiography, can be done to locate blockages. During angiography, the patient is injected with a dye that will track blood flow in the heart.

If the physician determines that coronary bypass surgery is the best treatment, the patient will need to check into a hospital. This surgery is done while the patient is under general anesthesia and it takes about six hours to complete. The patient should expect to stay in the hospital for six to ten days.

At least two surgeons are needed to complete the coronary bypass surgery. The first surgeon makes an incision through the breastbone or sternum to open the chest cavity. With the chest open, the heart is usually stopped and the patient is put on a heart-lung machine that will substitute for the heart. At the same time, the second surgeon is preparing an artery or vein for grafting. Either the mammary artery in the chest wall or the saphenous vein in the leg is used for this procedure.

The artery or vein is sutured in place beyond the blockage in the coronary artery. This should restore blood flow to the heart muscle. The heart is then restarted and the chest wall is closed. Patients should expect to stay in the intensive care unit of the hospital for one to three days. Complete recovery may take up to six weeks. Patients should contact the physician if they see signs of infection or bleeding at the incision.