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This is the most common type of heart surgery. You may also hear coronary artery bypass graft (CABG - pronounced "cabbage") surgery referred to as: coronary artery bypass (CAB), coronary bypass, or bypass surgery.
Arteries can become clogged over time by the buildup of fatty plaque. Bypass surgery improves the blood flow to the heart with a new route, or "bypass," around a section of clogged or diseased artery.
The surgery involves sewing a section of vein from the leg, arteries from the chest, or another part of the body to bypass a part of a diseased coronary artery. This creates a new route for blood to flow, so that the heart muscle will get the oxygen-rich blood it needs to function properly.
During bypass surgery, the breastbone (sternum) is divided, the heart is stopped, and blood is sent through a heart-lung machine. Unlike other kinds of heart surgery, the chambers of the heart are not opened during bypass surgery.
When you hear the words single bypass, double bypass, triple bypass, or quadruple bypass, it refers to the number of arteries that are bypassed. The number of bypasses does not necessarily indicate how severe the heart condition is.
Minimally invasive bypass surgery is a less invasive bypass surgery technique. The incision is smaller, and the procedure may be done while the heart is still beating. This reduces the risk of complications and may reduce patient recovery time.
This operation is only used for patients whose blockages can be bypassed through this smaller incision and whose risk of complications is low.
Off-pump coronary artery bypass (OPCAB) surgery offers the option to operate on a beating heart during coronary bypass surgery without relying on the heart-lung machine. This procedure reduces the risk of stroke, bleeding, kidney failure, cognitive dysfunction, and memory loss often associated with the use of the heart-lung machine.
To assist the surgeon while operating on the beating heart, medications are used to slow the heart rate, eliminating the need for a heart-lung machine. To allow for access to the entire heart, there must be a sufficient amount of cardiac displacement. This is accomplished by using specialized instruments to prop the heart in a position that allow the surgeon access to closed arteries.
If you have carotid artery disease, a carotid endarterectomy may be recommended. A carotid endarterectomy removes plaque from the inside of the arterial wall. An incision is made along the skin folds in the neck and a shunt (tube) may be used to supply blood to the brain during surgery. The treatment opens the artery to allow for normal blood flow to the brain and prevent plaque or emboli from going to the brain.
The surgery takes about two hours under general anesthesia. As with any surgical procedure, there are risks that your surgeon will discuss with you, along with the benefits of your surgery. In many cases, the surgery is recommended or performed to help prevent a stroke from occurring.