Coronary Artery Bypass Graft Surgery: How It Is Done - Topic Overview
Putting you on the heart-lung bypass machine continued...
While the ventilator physically inflates and deflates your lungs, the
bypass machine performs the lungs' main job of adding oxygen and removing
unwanted gases from your blood. Also, the machine circulates that blood
through your body.
After the heart-lung machine has been set up, the blood flowing from
your heart to the rest of your body will be stopped by clamping the aorta and
will be rerouted through the heart-lung bypass machine. Your anesthesiologist will then
inject a medicine through your IV (or squirt it directly onto your heart) to
stop your heartbeat immediately. Your heart will not beat again until the new
grafts have been put in place.
Bypassing your diseased coronary arteries
will start to operate on the coronary arteries. The harvested vein
in the sterile saline solution is cut into appropriate lengths. Your surgeon
will attach one end of the blood vessel to the aorta (or to the coronary
artery) and the other end onto a portion of the coronary artery past the
location in the artery where there is narrowing or blockage.
In the case of the LIMA or RIMA, one end remains attached to your
chest wall and the other end is connected to the coronary artery. Regardless of
which type of blood vessel is used, oxygen-rich blood is rerouted around the
narrowed or blocked section of the coronary artery and into a healthy section
where it can feed into the heart muscle.
Preventing blood loss during surgery
During the surgery, blood may spill into your chest cavity as small
blood vessels are cut. To prevent this blood from interfering with surgery, a
nurse or surgeon's assistant will use a suction device (which looks like a
large plastic straw) to suck up the blood. This device is
attached to the heart-lung machine. So if you are on this machine,
blood that is sucked up is actually returned to your body several
seconds later so that you don't lose too much blood. Despite this effort,
though, about half of the people who have CABG surgery end up needing a blood
Restarting your heart
If you are on the heart-lung bypass machine, your doctor
will restart your heart. After your bypass grafts have been sewn in
place with strong stitches (sutures), your doctor will take the clamp off of
your aorta. This will allow blood to flow to your heart, and the heart will
typically start to beat again.
When your heart starts to beat again, you will be taken off the
heart-lung bypass machine. Your surgeon may then apply a small electric shock,
or your anesthesiologist may administer another medicine to help your heart
muscle regain its natural rhythm.