During bypass surgery, your heart is examined and your surgeon will remove the necessary graft vessel for the artery bypass. After the graft is in place, small wires are placed onto the surface of your heart to help your heart beat normally after you have been removed from the bypass machine. Then tubes are placed inside your chest and your breastbone is brought back together.
(Technically speaking, an open heart surgery is any procedure where the chest is opened, which certainly includes procedures beyond a heart bypass (a valve replacement, for example). However, because a heart bypass is the most common type of open heart surgery, for the purposes of this article, we will be using the terms "bypass" and "open heart surgery" interchangeably.)
What Is Bypass Surgery?
Bypass surgery is a procedure that takes a blood vessel from somewhere else in the body and uses it to bypass a vessel in the heart that has become damaged and blocked. This improves the blood supply to the heart and, in turn, improves the delivery of oxygen and nutrients to the heart muscle.
Other names for bypass surgery include:
- Coronary artery bypass graft surgery
- Open heart surgery
- Heart bypass surgery
- Cardiac bypass surgery.
The Surgery Itself
After your anesthesia takes effect (see Anesthesia for Bypass Surgery), the surgical area will be scrubbed with a special disinfectant soap and may also be shaved.
Your surgeon will then make a six- to eight-inch incision down the middle of your chest. Your breastbone is then separated, the heart sac is carefully pulled back, and your heart is examined.
At this point, your doctor will remove the necessary graft vessel for the artery bypass. Most commonly, an artery from the chest (called the mammary artery) and/or a vein from your leg is used. An artery from your arm or wrist may also be used.
Once this is done, the bypass surgery can continue. At this point, your heart will need to be cooled to keep it still. During this time, your heart will be connected to the heart-lung bypass machine.
After giving you a large dose of a blood-thinning medicine called heparin (to make sure that your blood does not clot), your surgeon will connect your heart to the heart-lung bypass machine with a plastic tube. Blood from your heart is then sent to the bypass machine through this tube. The machine supplies your blood with oxygen and then pumps it back to the rest of your body through the other tube. While connected, your blood simply bypasses your heart and your lungs, but still reaches the rest of your body.
After you are successfully connected to the heart-lung bypass machine, each of your blocked coronary arteries will be carefully inspected. Your surgeon will determine the ideal place to attach the new vessel or vessels. Usually, the vessel is sewn into an area below the blockage and then into a location in the aorta.