If you suffer blocked or damaged coronary arteries, a coronary artery bypass (CABG) could be the most effective option to restore blood flow to the heart. This procedure uses blood vessels from other parts of the body to make a new route for blood to flow around blocked coronary (heart) arteries. A bypass is the most common type of open-heart surgery in the United States.
At TriStar Cardiovascular Surgery, we treat provide state-of-the-art treatments for even the most complex cardiac procedures. Our expert cardiac surgeons have many years of experience performing traditional open-heart surgery as well as other techniques for heart bypass surgery:
- Arrested heart coronary bypass – performed while the heart is stopped and connected to a heart-lung machine
- On-pump beating heart bypass - performed on the heart while it is beating. The heart will not be stopped during surgery, the heart and lungs will continue to perform in surgery and heart-lung machine may not be needed.
- Off-pump bypass – performed without a heart-lung machine
- Minimally Invasive bypass (MISC CABG) - A minimally invasive approach that allows bypass surgery on the heart through small incisions without separating the breastbone (sternum).
Reasons for Bypass Surgery
Atherosclerosis is a buildup of cholesterol that is inappropriately deposited into your arteries. When the buildup becomes severe, it restricts blood from. This could happen with or without myocardial infarction (heart attack). Restricted blood flow also causes chest pain, or angina. When the blockage gets too severe, CABG is needed to re-establish blood supply to the heart muscle.
The morning of your procedure, you will be admitted and the anesthesiologist will place special IVs needed during the procedure and a light sedation will be given at this time. They will also prep your skin appropriately. You will be given a breathing tube to receive oxygen during your heart surgery. At this time, a transesophageal echocardiogram (TEE) is performed to see how well the heart is pumping and allows a better look at the valves. This test is also done at the end of the procedure to note improvement in your heart function. Next, your doctor will make an incision into your chest to expose your heart. You are then connected to the heart-lung machine which will circulate your blood to provide oxygen.
Most likely, your heart surgeon will use an artery from behind your breast and place it to the blockage on the left side of the heart. Veins will be taken from your legs, from behind the knee with an endoscope. The vein is attached to the aorta (the large artery leaving the heart) and then connected past the area of the blockage. This process is used for all remaining blockages. When all of the grafts are in place, the heart will be allowed to “wake up” and the heart-lung machine will be disconnected. Temporary tubes and pacing wires are placed in your chest and the breastbone is wired together. The chest will be closed with stiches and you’ll be taken to the Cardiovascular Intensive Care Unit (CVICU) to recover.
During your heart surgery, your family will go to the cardiovascular waiting room on the 3rd floor. After the doctor makes the first incision, the nurse will notify the family and provide continuous updates about every hour and a half.Learn more about preparing for heart surgery >>
Upon arrival into the CVICU, your care team of nurses will monitor your blood pressure and pressures inside your heart. X-rays and labs may be performed periodically to check the status of your condition. As soon as you are fully awake, the breathing tube is removed and the drains that were placed in your chest will be hooked to a Pleurevac (canister) remove any drainage. You’ll spend at least one night in the CVICU where you’ll be given medication to relieve your pain. If you have any problems like elevated blood pressure or respiratory issues, you may be required to stay longer. Your doctor and care team will keep you and your family updated on your progress throughout the entire process. When you’re released from the CVICU, you’ll go to the cardiac step-down unit on the 5th floor. After about 4-7 days you can go home. We will walk you through the entire journey to recovery and make sure you feel safe walking and doing your daily activities.Learn more about recovering from heart surgery >>