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Coronary artery bypass graft surgery requires a stay in a hospital. Procedure may vary depending on your condition and your physician's practices.
Generally, a coronary artery bypass surgery follows this process:
You will be asked to remove any jewelry or other objects that may interfere with the procedure.
You will be asked to remove your clothing and will be given a gown to wear.
You will be asked to empty your bladder prior to the procedure.
An intravenous (IV) line will be started in your arm or hand. Additional catheters will be inserted in your neck and wrist to monitor the status of your heart and blood pressure, as well as for obtaining blood samples. Alternate sites for the additional catheters include the subclavian (under the collarbone) area and the groin.
You will be positioned on the operating table, lying on your back.
The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery. Once you are sedated, a breathing tube will be inserted through your throat into your lungs and you will be connected to a ventilator, which will breathe for you during the surgery.
A catheter will be inserted into your bladder to drain urine.
The skin over the surgical site will be cleansed with an antiseptic solution.
Once all the tubes and monitors are in place, an incision may be made in one of your legs to obtain a section of vein to be used for grafts.
The physician will make an incision (cut) down the center of the chest from just below the Adam's apple to just above the navel.
The sternum (breastbone) will be divided in half with a special operating instrument. The physician will separate the two halves of the breastbone and spread them apart to expose the heart.
In order to sew the grafts onto the very small coronary arteries, the heart must be stopped to allow the physician to perform the very delicate procedure. Tubes will be inserted into the heart so that the blood can be pumped through your body by a cardiopulmonary bypass machine.
Once the blood has been diverted into the bypass machine for pumping, the heart will be stopped by injecting it with a cold solution.
When the heart has been stopped, the physician will perform the bypass graft procedure by sewing one end of a section of vein over a tiny opening made in the coronary artery just above the blockage, and the other end over a tiny opening made in the coronary artery just below the blockage. If the internal mammary artery inside your chest is being used as a bypass graft, the lower end of the artery will be cut from inside the chest and sewn over an opening made in the coronary artery below the blockage.
You may have more than one bypass graft performed, depending on how many blockages you have and where they are located. After all the grafts have been completed, the physician will examine them to make sure they are working.
Once the bypass grafts have been completed, the blood circulating through the bypass machine will be allowed back into your heart and the tubes to the machine will be removed. Your heart will be restarted.
Temporary wires for pacing may be inserted into the heart. These wires can be attached to a pacemaker and your heart can be paced, if needed, during the initial recovery period.
Once the chest has been opened, the area around the artery to be bypassed will be stabilized with a special type of instrument.
The rest of the heart will continue to function and pump blood through the body.
The cardiopulmonary bypass machine and the perfusionist who runs it may be kept on stand-by should the procedure need to be completed on bypass.
The physician will perform the bypass graft procedure by sewing one end of a section of vein over a tiny opening made in the coronary artery just above the blockage, and the other end over a tiny opening made in the coronary artery just below the blockage.
You may have more than one bypass graft performed, depending on how many blockages you have and where they are located.
Before the chest is closed, the physician will examine the grafts to make sure they are working.