Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to reach your heart. It is done to fix problems caused by coronary artery disease (CAD), in which the arteries that lead to your heart are partly or totally blocked.
See also:
Alternative NamesOff-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery - heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery
DescriptionBefore your surgery you will receive anesthesia. This will make you unconscious and unable to feel pain. The effects of the anesthesia will last the entire procedure.
Once you are unconscious, the heart surgeon will make a 10-inch-long incision (cut) in the middle of your chest. Then your breastbone will be separated to create an opening that allows the surgeon to see your heart and aorta (the main blood vessel leading from the heart to the rest of your body).
Most people who have coronary bypass surgery are connected to a heart-lung bypass machine, or bypass pump.
A newer method does not use the heart-lung bypass machine. The bypass is created while your heart is still beating. This is called off-pump coronary artery bypass, or OPCAB. This method may be used for patients who could have problems from being on the heart-lung machine.
During this surgery, the doctor takes a vein or artery from another part of your body and uses it to create a detour (or graft) around the blocked area in your artery.
After the graft has been created, your breastbone will be reconnected with wire, and your incision will be sewn closed. The wire will remain inside you.
This surgery can take 4 to 6 hours. After the surgery, you will be taken to the Intensive Care Unit.
Why the Procedure Is PerformedCoronary arteries are the small blood vessels that supply your heart with oxygen and nutrients that are carried in your blood.
When one or more of the coronary arteries becomes partly or totally blocked, your heart does not get enough blood. This is called ischemic Heart disease, or coronary artery disease (CAD). It can cause chest pain (angina).
Coronary artery bypass surgery can be used to treat coronary artery disease. Your doctor may have tried to treat you with medicines only. You may have also tried cardiac rehabilitation.
CAD varies a lot from person to person, so the way it is diagnosed and treated will also vary. Heart bypass surgery is just one treatment. It will be right for some people, but others may have other kinds of treatment.
RisksRisks for any surgery are:
Possible risks from having coronary bypass surgery are:
Always tell your doctor or nurse what drugs you are taking, even drugs or herbs you bought without a prescription.
During the days before your surgery:
The day before your surgery:
On the day of the surgery:
Your doctor or nurse will tell you when to arrive at the hospital.
After the ProcedureAfter the operation, you will spend 5 to 7 days in the hospital. You will spend the first few hours in an intensive care unit (ICU).
Two to 3 tubes will be in your chest to drain fluid from around your heart. They are usually removed 1 to 3 days after surgery.
You may have a catheter (flexible tube) in your bladder to drain urine. You may also have intravenous (IV) lines for fluids. There will be monitors that give information about your vital signs (pulse, temperature, and breathing). Nurses will watch your monitors constantly.
Usually within 24 hours, you will be moved to a regular or a transitional care unit in the hospital, and you will slowly resume some activity. You may begin a cardiac rehabilitation program within a few days.
It takes 4 to 6 weeks to start feeling better after surgery.
Outlook (Prognosis)Recovery from surgery takes time, and you may not see the full benefits of your surgery for 3 to 6 months. In most people who have heart bypass surgery, the grafts remain open and working well for many years.
But, this surgery does NOT prevent the coronary artery blockage from coming back. You can do many things to slow it down. Not smoking, eating a heart-healthy diet, getting regular exercise, and treating high blood pressure, high blood sugar (if you have diabetes), and high cholesterol will all help and are very important.
You may be more likely to have problems with your blood vessels if you have kidney disease or some other medical problems.
ReferencesFerraris VA, Mentzer RM Jr. Acquired heart disease: coronary insufficiency. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 61.
Fraker TD Jr, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J, et al. 2007 chronic angina focused update of the ACC/AHA 2002 guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 guidelines for the management of patients with chronic stable angina. Circulation. 2007;116(23):2762-2772.
Hannan EL, Wu C, Walford G, Culliford AT, Gold JP, Smith CR, et al. Drug-eluting stents vs. coronary-artery bypass grafting in multivessel coronary disease. N Engl J Med. 2008;358:331-341.
Heart bypass surgery begins with an incision made in the chest, with the breastbone cut exposing the heart. Next, a portion of the saphenous vein is harvested from the inside of the leg. Pieces of this great vein will be used to bypass the blocked arteries in the heart. The venous graft is sewn to the aorta and to the affected coronary artery past the blocked site. The internal mammary artery from the chest may also be used to bypass a clogged artery. Several arteries may be bypassed depending on the condition of the heart.
Reviewed ByReview Date: 05/06/2011
Shabir Bhimji MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to reach your heart.
See also:
Alternative NamesOff-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery - heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery
DescriptionBefore your surgery you will get general anesthesia. You will be asleep (unconscious) and pain-free during surgery.
Once you are unconscious, the heart surgeon will make a 8-10-inch surgical cut (incision) in the middle of your chest. Your breastbone will be separated to create an opening. This allows your surgeon to see your heart and aorta, the main blood vessel leading from the heart to the rest of your body.
Most people who have coronary bypass surgery are connected to a heart-lung bypass machine, or bypass pump.
A newer type of bypass surgery does not use the heart-lung bypass machine. The bypass is made while your heart is still beating. This is called off-pump coronary artery bypass, or OPCAB. This procedure may be used if you could have problems while on the heart-lung machine.
During bypass surgery, the doctor takes a vein or artery from another part of your body and uses it to make a detour (or graft) around the blocked area in your artery.
After the graft has been created, your breastbone will be closed with wire. This wire stays inside you. The surgical cut will be closed with stitches.
This surgery can take 4 to 6 hours. After the surgery, you will be taken to the intensive care unit.
Why the Procedure Is PerformedYour doctor may recommend this procedure if you have a blockage in one or more of your coronary arteries. Coronary arteries are the small blood vessels that supply your heart with oxygen and nutrients that are carried in your blood.
When one or more of the coronary arteries becomes partly or totally blocked, your heart does not get enough blood. This is called ischemic heart disease, or coronary artery disease (CAD). It can cause chest pain (angina).
Coronary artery bypass surgery can be used to treat coronary artery disease. Your doctor may have first tried to treat you with medicines. You may have also tried cardiac rehabilitation or angioplasty with stenting.
Coronary artery disease is different from person to person. The way it is diagnosed and treated will also vary. Heart bypass surgery is just one treatment. It is not right for everyone.
RisksRisks for any surgery include:
Possible risks from having coronary bypass surgery include:
Always tell your doctor or nurse what drugs you are taking, even drugs or herbs you bought without a prescription.
During the days before your surgery:
The day before your surgery:
On the day of the surgery:
Your doctor or nurse will tell you when to arrive at the hospital.
After the ProcedureAfter the operation, you will spend 3 to 7 days in the hospital. You will spend the first night in an intensive care unit (ICU). You will probably be moved to a regular or transitional care room within 24 hours.
Two to three tubes will be in your chest to drain fluid from around your heart. They are usually removed 1 to 3 days after surgery.
You may have a catheter (flexible tube) in your bladder to drain urine. You may also have intravenous (IV) lines for fluids. You will be attached to machines that monitor your pulse, temperature, and breathing. Nurses will watch your monitors constantly.
You will be encouraged to restart some activities and may begin a cardiac rehabilitation program within a few days.
It takes 4 to 6 weeks to start feeling better after surgery.
Outlook (Prognosis)Recovery from surgery takes time. You may not see the full benefits of your surgery for 3 to 6 months. In most people who have heart bypass surgery, the grafts stay open and work well for many years.
This surgery does not prevent the coronary artery blockage from coming back. You can do many things to slow this process down, including:
You may be more likely to have problems with your blood vessels if you have kidney disease or continue to smoke.
ReferencesFerraris VA, Mentzer RM Jr. Acquired heart disease: coronary insufficiency. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 61.
Morrow DA, Boden WE. Stable ischemic heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 57.
Hannan EL, Wu C, Walford G, Culliford AT, Gold JP, Smith CR, et al. Drug-eluting stents vs. coronary-artery bypass grafting in multivessel coronary disease. N Engl J Med. 2008;358:331-341.
MA¸ller CH, Perko MJ, Lund JT, Andersen LW, Kelbaek H, Madsen JK, Winkel P, Gluud C, SteinbrA1/4chel DA. No major differences in 30-day outcomes in high-risk patients randomized to off-pump versus on-pump coronary bypass surgery: the best bypass surgery trial. Circulation. 2010 Feb 2;121(4):498-504.
Reviewed ByReview Date: 05/06/2011
Shabir Bhimji MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The Gastric Bypass Surgery is a procedure that reduces the size of your stomach, to help weight loss. On the other hand, a Heart Bypass Surgery is a procedure that replaces a block blood vessel in you heart with another blood vessel.
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Do not change the way you perform CPR for someone with recent heart bypass surgery.
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Open heart bypass surgery.
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The most detailed and relevant information about heart bypass surgery can be obtained from a medical provider. Other sources for general information about heart bypass surgery are websites like WebMD or magazine and newspaper articles that can be obtained online or in print.
3 vessel bypass surgery. Open heart surgery that bypasses 3 arteries. Aortocoronory bypass =acb
You can find out more about it here: www.webmd.com/heart-disease/heart-disease-bypass-surgery. Please be sure to check with your doctor to see if it is right for you.
There are many places where you can get this information. You can go to en.wikipedia.org/wiki/Coronary_artery_bypass_surgery or www.webmd.com/heart-disease/heart-disease-bypass-surgery.
How soon can you fly after heart bypass surgery