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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

Your surgeon 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 transfusion.

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.


WebMD Medical Reference from Healthwise

Last Updated: September 18, 2012
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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