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Open-Heart Surgery (Coronary Artery Bypass Graft)

Open-heart surgery is a medical procedure also known as coronary artery bypass graft (CABG). In this procedure, the blood flow is re-routed through a new artery or vein that is grafted around diseased sections of your coronary arteries to increase blood flow to the heart’s muscle tissue. This procedure is also called coronary artery bypass surgery. A bypass typically requires open-chest surgery and the use of a heart-lung bypass machine to circulate the blood and add oxygen.

Bypass surgery is usually performed for heart attack only when other treatments, such as medication and angioplasty with or without stenting, are not useful because of the location or extent of the blockage.

Although new techniques have allowed doctors to use angioplasty and/or stenting increasingly more than bypass surgery, some types of heart attack may not be effectively treated with these methods. Bypass may be a better option for people with diabetes. It may also be a better option when certain areas of the heart are damaged or when angioplasty is not possible for technical reasons.

For the bypass grafts, your surgeon will use either an artery or another vein from your body.
A vein may be removed from your leg. One end of the vein is attached to the aorta and the other end to the diseased coronary artery just past the blocked area. Another option is to detach and re-attach one end of a mammary artery or another artery in the chest to the coronary artery just past the blocked area. In either case, blood is redirected through the artery or vein graft, detouring the blocked or narrowed artery and increasing blood flow to that region of the heart.

After surgery, there will be a short stay in the intensive care unit (ICU). In the ICU, you will likely have:
Continuous monitoring of your heart activity
A tube to temporarily help with breathing
A central line, which is a thin plastic tube inserted into a vein in the neck and threaded down into the heart and pulmonary artery, to monitor pressures and blood flow within the heart
A tube to remove stomach secretions until you start to eat again
A tube (catheter) to drain the bladder and measure urine output
Tubes connected to veins in the arms (IV lines) through which fluids, nutrition and medication can be given
An arterial line to measure blood pressure (An arterial line is a short, soft, plastic tube, also known as a catheter, that is placed directly into an artery). The arterial line leads to a monitor, which continuously displays blood pressure
Chest tubes to drain the chest cavity of fluid and blood (which is temporary and normal) after surgery

Recovery includes physical therapy, respiratory therapy, occupational therapy and diet counseling. You will typically stay in the hospital from three to eight days after open-chest bypass surgery. The amount of time you stay varies and will depend on your health before bypass surgery and whether complications develop from the surgery.


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