Cardiovascular system Coronary artery bypasses

The coronary arteries (vessels that take oxygen-rich blood to the heart) can become diseased, with narrowing and until a full obstruction by atheroma plaques inside them. These plaques are formed by deposition of fat, cholesterol, clots, and other substances. Such obstructions cause a reduction in the blood flow to the heart, and can cause angina or infarction. The coronary artery bypasses, also called as myocardial revascularization surgeries, are a cardiac surgery type where a bypass is made over the place presenting narrowing or obstruction. Consequently, there is an improvement in the blood and oxygen flow to the heart. The mammary artery (located in the thorax) and/or a segment of the saphenous vein (located in the leg) are used to make such bypasses.

Figure 1. Bypass made from mammary artery

The surgeon removes a segment of a healthy blood vessel from other body portion to make a bypass and to surpass the diseased portion of the coronary. The mammary artery can be removed from inside the thorax, by the same incision, and can be sutured together with the coronary, just ahead the obstruction site. A piece of the saphenous vessel can be also used, depending on the needed number of bypasses. A tip is sutured to the coronary and the other is sutured to the aorta. Once the bypasses are implanted, the blood uses this new pathway to irrigate the cardiac muscle.

THE CORONARY ARTERY BYPASS, ALSO KNOWN AS MYOCARDIAL REVASCULARIZATION SURGERY, IS A TYPE OF CARDIAC SURGERY WHERE A BYPASS IS MADE OVER AN ARTERY PRESENTING NARROWING OR OBSTRUCTION CAUSED BY FAT PLAQUES, SO IMPROVING THE BLOOD AND OXYGEN FLOW TO THE HEART.

Postoperatory

After the surgery, the patient stays for about 2 days in a cardiac ICU, with heart rate and arterial pressure being continuously monitored. The anesthesia tube for breathing is removed as soon as the patient wakes up. Medicines are administered in the vein for controlling the pain and, if needed, for controlling the pressure. The relatives may visit 3 times daily. After that, the patient is transferred to the room, where he/she stays for more 3 or 4 days.

Support notes

Angina or infarction: Consequences of the narrowing of the coronary arteries, which impair the blood flow to the heart. Click here to go to the page of Ischemic Cardiopathy and to know more about this subject.

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