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This is a
surgery in which a healthy blood vessel (artery) is used toform a detour
(bypass) around a blockage in a coronary (heart) artery. The new blood vessel
used is called a ‘graft’ and therefore the
procedure is
correctly termed as ‘Coronary Artery Bypass Graft’
surgery. The
original blockage in the artery remains as it is, but nowthere is adequate blood
supply to the heart muscle beyond the blockage.
Today coronary
artery bypass is one of the most frequently performed surgical procedures.
How is it
done?
The ‘graft’
used can be either an artery or a vein. However, these days most advanced heart
centers such as the Asian Heart Institute prefer to use ‘arterial grafts’ since
they have been shown to have a longer life. Studies performed at the Cleveland
Clinic by Dr. Floyd Loop and others have shown that arterial grafts remain open
even after 20 years of surgery. When surgery is done only using arteries as
grafts (also called ‘Total Arterial Revascularization’), the chances of getting
recurrence of angina are very slim, and in most cases the patient does not need
a second bypass surgery. In the past ‘venous grafts’, usually from a vein in the
leg called saphenous vein were used
often, but they
have a higher rate of developing fresh blockages.The most common artery used is
an artery from your chest called the Left Internal Mammary Artery (LIMA). This
artery is detached from the chest wall and the open end attached to the coronary
artery below the blockage. The RIMA can also be used in select cases. The radial
artery is another very commonly used conduit vessel in bypass surgeries. It’s
typically taken from the non-dominant hand. |
