Coronary artery bypass graft surgery treats hearts with coronary artery disease in which fatty deposits build up in the heart (coronary) arteries, restricting blood flow to the heart and potentially leading to chest pain, or angina. These deposits, or plaques, can also be vulnerable to rupturing. When a plaque ruptures, a blood clot can form at the site of the rupture, cutting off blood flow to the heart and causing a heart attack
Think of a highway bypass that allows you to drive around traffic congestion in a city. Or a detour that takes you around a road that is obstructed and needing repair. The bypass or detour takes you from the normal road, goes around the blockage, and then brings you back to the smooth road. Bypass surgery takes blood flow around and away from the diseased portion of the blood vessel, and re-routes it to the healthy part of the vessel. The new blood vessel allows blood to bypass the diseased, clogged artery and travel freely to the heart.
During bypass surgery, a heart surgeon removes a blood vessel from one of several sites in the body to use as the bypass graft. The most successful bypasses use the internal mammary artery – the artery that runs just inside the edge of each side of the breastbone. During bypass surgery, the end of this blood vessel is removed from the chest wall to be used to attach to the heart beyond the blockage.
The beginning of the internal mammary artery is left in place, which is the artery beneath the collarbone. In this way, blood flowing in the normal route up toward the collarbone flows down the internal mammary artery normally, except now it is joined to the coronary artery of the heart. Like the road detour, it has bypassed the obstruction.
The surgeon may also remove a segment of blood vessel from the leg (saphenous vein) or wrist (radial artery). The surgeon then attaches this new blood vessel (the graft) to the aorta (the major artery originating from the heart). The other end of the graft is then attached to the coronary artery below the blockage that is being treated. The graft allows blood to flow from the aorta, down the graft to bypass the blockage, and restore flow to the heart muscle.
Coronary artery bypass graft surgery can save your life or that of a loved one, and it can improve your quality of life. If you are about to have bypass surgery or are recovering now, you probably have many questions about the procedure and the practical aspects of getting back to daily life. Learning more about the surgery can put your mind at ease and help you manage stress to move forward for a positive recovery