Bypass Surgery

What Is Heart Bypass Surgery?

Heart bypass surgery, also known as coronary artery bypass surgery or open heart surgery bypass, aims to replace damaged arteries in the heart. A surgeon uses blood vessels from another area of the body to repair the damaged arteries.

This surgery is used when the coronary arteries become blocked or damaged. The coronary arteries supply the heart's muscles with oxygenated blood. If they are blocked or the flow of blood is restricted, the heart can't function properly. This can lead to heart failure. According to the Centers for Disease Control (CDC), doctors perform 395,000 such surgeries in the United States each year.

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Heart Bypass Surgery


  1. The patient is brought to the operating room and moved onto the operating table.
  2. An anaesthetist or anesthesiologist places intravenous and arterial lines and injects an analgesic, usually fentanyl, intravenously, followed within minutes by an induction agent (usually propofol or etomidate) to render the patient unconscious.
  3. An endotracheal tube is inserted and secured by the anaesthetist and mechanical ventilation is started. General anaesthesia is maintained with an inhaled volatile anesthetic agent such as isoflurane.
  4. The chest is opened via a median sternotomy and the heart is examined by the surgeon.
  5. The bypass grafts are harvested ' frequent vessels are the internal thoracic arteries, radial arteries and saphenous veins. When harvesting is done, the patient is given heparin to inhibit blood clotting.
  6. In the case of “off-pump” surgery, the surgeon places devices to stabilize the heart.
  7. In the case of “on-pump” surgery, the surgeon sutures cannulae into the heart and instructs the perfusionist to startcardiopulmonary bypass (CPB). Once CPB is established, there are two technical approaches: either the surgeon places the aortic cross-clamp across the aorta and instructs the perfusionist to deliver cardioplegia with a cooled potassium mixture to stop the heart and slow its metabolism or performing bypasses on beating state (on-pump beating).
  8. hout complications is discharged in four or five days.

Why You May Need Heart Bypass Surgery

When plaque, which is a material in the blood, builds up on the walls of the arteries, there's less blood flow to the heart muscle. Since the heart is not receiving adequate blood, the muscle is more likely to tire and fail. This type of damage most often affects the left ventricle, the heart's primary pump.

Doctors recommend heart bypass surgery if your coronary arteries become so narrowed or blocked that you run a high risk of a fatal heart attack. This condition is called coronary artery disease, or atherosclerosis. Bypass surgery is performed when the blockage is too severe to be managed with medication or other treatment.

How Is the Need for Bypass Surgery Determined?

Prior to the surgery, a team of physicians, along with a cardiologist, will identify whether or not you can safely undergo open-heart surgery. Some medical conditions can complicate surgery or eliminate it as a possibility altogether.

Conditions that can cause complications include:

  • diabetes
  • emphysema
  • kidney disease
  • peripheral artery disease

Tell your doctor about these issues along with family history, prescription and over-the-counter medications before any surgery is scheduled. In general, outcomes are better for planned surgery than emergency surgery.

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