Coronary Artery Bypass Graft Surgery: How It Is Done - Topic Overview
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.
Closing your chest cavity
Prior to closing up your sternum, your surgeon will place several small tubes inside your chest cavity, with one end exiting your body through an incision in your upper abdomen. These tubes allow drainage of any extra fluids from your chest. Your surgeon will then close your rib cage and use metal wires to bring the two halves of your sternum back together.
Finally, your surgeon will sew the soft tissues and muscles in your chest together with extra-strong stitches, or sutures. Surgery without complications usually takes 3 to 6 hours, depending on how many coronary arteries are bypassed.
Although the CABG procedure is considered a relatively safe procedure, it also involves certain risks. It is important that you educate yourself about the risks of CABG surgery beforehand and talk with your surgeon about how your current health condition will affect your risk for complications.