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Coronary Artery Bypass Graft Surgery: How It Is Done - Topic Overview

Putting you on the heart-lung bypass machine

After your coronary arteries have been exposed and a usable blood vessel segment has been harvested, your surgical team may place you on a heart-lung bypass machine. Alternately, your surgical team may do the operation while your heart is beating. If you are placed on the heart-lung bypass machine, your heart will be temporarily stopped during the surgery so your surgeon can perform surgery on your coronary arteries. The heart-lung bypass machine does the work of your heart and lungs so that all the parts of your body still receive the oxygen-rich blood they need to survive.

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.

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