There are many people who have had coronary artery bypass in the United States. It is very common due to the prevalence of coronary artery disease in the United States. But what is it actually? There are those who might be reading this article right now, who might have had the surgery performed and still remain without an adequate understanding of this type of corrective surgery. Before going into an explanation of the procedure, let’s do a layman’s overview of the coronary arteries, their function, and how they are affected by disease.
Coronary arteries are the blood vessals that supply oxygenated blood to the heart muscle. There are two main coronary arteries; the left coronary artery and the right coronary artery. In order to visualize what they would look like, take your hand, spread your fingers out and pretend as if you are grasping a melon. Your palm should be facing downward. Your left coronary artery looks very similar with many branches, supplying blood to the muscle wall of the left side.
Now, take your right hand; using your index finger and thumb, create the shape of a “C”. This is a fairly decent picture of your right coronary artery, which supplies blood to the right side of your heart. They are in essence little tubes that transport blood to a heart, which is constantly pumping blood to the body. They are important because if there is any occlusion to the area being supplied, it can result in death of the muscle in that area, which can decrease the heart’s ability to pump blood.
Coronary artery disease occurs when plaque builds up in the coronary arteries. Plaque is composed of fat, cholesterol, calcium, and other substances found in the blood. The buildup of plaque is called atherosclerosis.
So how do doctors know whether or not, there is plaque in the coronary arteries? Well, in many cases they won’t until either you start suffering from symptoms such as chest pain or shortness of breath and end up having testing done. Unfortunately, in many cases, it is not found until one suffers from myocardial infarction or tissue death in the heart. When this happens, they may perform a cardiac catheterization to actually visualize the coronary arteries.
How do they do this? In a sterile laboratory, they make an incision in the groin area, insert a long slender catheter and advance it to the coronary arteries. Afterward, they inject a radiolucid dye and take images of your heart with an type of X-ray procedure called angiography. During this procedure, they may be able to advance a balloon across the plaque, inflate it to flatten the plaque against the walls, and use a stentto keep it in place. However, if for some reason, they are unable to get through the plaque and it is occluding 70 percent of the vessel, they will send you off for a bypass.
Coronary artery bypass is not as horrible as it might seem. Yes, it is open heart surgery and very serious but necessary to save your life. The theory behind it is no different than the following example. Just imagine if your were traveling down the interstate to get to work. You have two different routes. You can either go through downtown or take the bypass access road, which veers off for a distance but eventually returns you to the same route. If there is excessive traffic, you take the access road so that you can complete your trip.
Coronary bypass is no different. Only there is no ready-made access road. It will have to be constructed by your surgeon, using a similar vessel from your own body. He might decide to take one from your leg or your arms. Most surgeons tend “harvest” veins from the legs. One end is sewn above the blocked area, and the other end of the vein is attached or “grafted” to the coronary artery below the blocked area . This will assist in rerouting the blood around the damaged area so that the heart can continue pumping effectively. Double, triple, and quadruple bypass are terms used to describe the number of vessels your surgeon has rerouted.
