Preparation for heart surgery begins with the shaving and disinfecting of the chest. A narrow, soft tube called an intravenous catheter, or IV, will be placed in one or both of the patient's arms to provide fluids and medication during and after surgery. Another catheter will be placed in the side of the patient's neck.
During the bypass operation, surgeons take a blood vessel from another part of the patient's body and construct a detour around the blocked portion of the coronary artery. One vein that is commonly used to create this detour a greater saphenous vein from the leg. Often, arteries in the chest, such as the left internal mammary artery, or LIMA, are used for grafts. Another vessel used for grafts in coronary artery bypass surgery is the radial artery from the wrist and the forearm, which feeds blood to the hand. Typically, the saphenous vein is removed by endoscopic vein harvesting.
Almost all coronary bypass surgeries use a heart-lung machine, which enables a surgeon to stop the heart from beating while he or she sews tiny arteries and veins together to form grafts. The heart-lung machine performs the pumping and oxygenation functions of the heart. When the grafts have been completed, the heart is stimulated to begin pumping blood again and the heart-lung machine is removed.
Some surgeons now perform minimally invasive coronary artery bypass, or keyhole surgery. The same techniques are used as in beating-heart surgery, but instead of performing a full sternotomy, or opening the patient's chest by cutting through and separating the breastbone, surgeons make small incisions-or keyholes-between the ribs to access the heart.
Coronary bypass surgery usually takes 2 to 5 hours. After the surgery is completed, the patient typically spend about 24 to 72 hours in the intensive care unit of the hospital. The patient is then moved to the cardiac care discharge in 3 to 7 days. Recovery takes 1 to 2 months.