Traditional Coronary Artery Bypass Graft Surgery

Overview

During this procedure, the surgeon bypasses a severely blocked artery in the heart with a healthy blood vessel. This restores vital blood flow to the heart muscle.

Preparation

In preparation for the bypass, the patient is positioned and anesthesia is administered. The surgeon harvests a healthy blood vessel from a donor site. This is called a graft. The graft is commonly taken from the patient’s leg or arm. The surgeon opens the patient’s chest to expose the heart.

Heart is Stopped

The patient’s blood flow is diverted to a heart-lung machine. This machine temporarily takes over the lung’s function of oxygenating the blood and the heart’s function of pumping blood to the body. The surgeon then clamps the aorta. A medication is administered to stop the patient’s heart and preserve it during the surgery.

Graft Attached

The surgeon identifies the blockage and prepares the graft. The surgeon carefully attaches one end of the graft to the blocked blood vessel at a point below the blockage.

Bypass Created

The surgeon attaches the other end of the graft to the aorta. If the patient has more than one blockage, multiple grafts may be required.

Mammary Artery

In some cases, the surgeon is able to perform the bypass with a mammary artery. If a mammary artery is used, only one end needs to be detached. The detached end is connected below the blockage. The other end is already connected to a fresh blood supply, and does not need to be sewn to the aorta.

Clamp Removed

After the bypass is complete, the surgeon removes the clamp from the aorta and allows the heart to resume beating on its own.

End of Procedure

The patient is slowly taken off the heart-lung machine. The surgeon may insert a temporary pacing wire. This wire can be connected to a pacemaker if needed. The chest is closed, and a drainage tube is left in place to prevent blood or fluid from building up around the heart.