Download coronary bypass

CORONARY BYPASS
Your doctor has determined that you need to have a coronary bypass. This pamphlet you
explains how the heart functions and the main steps in the surgery.
YOUR HEART
The heart is a muscle located in the center of the
chest between the lungs. It works like a pump,
circulating blood in order to provide the body with
oxygen and nutrients.
The coronary arteries are
located on the surface of the
heart, providing it with blood
and oxygen. They divide into
smaller vessels entering the
heart and that divide, in turn,
into many smaller branches.
Valves
Coronary arteries
Atrium
CORONARY BYPASS
Ventricle
The parts of the heart are the atria, ventricles,
valves, and coronary arteries.
Blood circulates in four chambers referred to as
atria and ventricles. The upper two chambers are
the atria; the lower two are the ventricles.
The heart has four valves that are flap-like tissue
structures that open and close with each heartbeat.
The valves allow blood to pass through the atria
and ventricles, ensuring that blood flows in the right
direction.
When plaque narrows or blocks a heart artery, less
blood reaches the heart, which can cause certain
symptoms, including shortness of breath and pain.
To reestablish blood flow
in the heart and relieve
the symptoms, your
doctor will recommend
you have coronarybypass surgery. This
surgery consists in
diverting the flow of
blood around the blocked
section to restore proper
blood flow.
MAIN STEPS OF THE
SURGERY
General Anesthesia
Before putting you under, the care team will
connect you to a cardiac monitor (which measures
arterial pressure), a saturometer (which measures
blood oxygen level), and an IV drip . Then, you will
be anesthetized (put to sleep).
Mammary artery
Once you have been put to sleep, a tube will be
installed to help you breathe as well as a urinary
catheter and venous-access lines. An anesthetist
will monitor you during the procedure.
Opening the Sternum (Sternotomy)
Usually, the surgeon will perform a sternotomy.
This technique consists in sawing your sternum in
half vertically and in separating the two sides. This
approach gives the surgeon access to your heart.
Harvesting Veins or Arteries
One or more incisions will be made in your leg
(saphenous vein) or arm (radial artery) to harvest a
segment of a vein or artery that the surgeon will
use for the bypass.
Saphenous vein or radial artery
Your surgeon may decide to perform the surgery
with your heart beating or stopped (extracorporeal
circulation). He or she will determine the most
appropriate approach depending on the type of
surgery required, the level of complexity, and your
state of health. The surgeon will discuss these
options with you.
Beating-Heart Surgery
Your heart will continue to beat during the surgery.
Temporarily Stopping the Heart
(extracorporeal circulation)
Your heart will be temporarily stopped and
connected to a cardiopulmonary bypass pump.
This device is often referred to as a heart–lung
machine because it takes over their functions.
Closing the Sternum
At the end of the operation, your sternum will be
put back into its normal position and attached with
steel wires.
IMPORTANT
 If you have to cancel or postpone your
admission.
 If you have a cold, the flu, a fever, or an
infection the day before your surgery.
Promptly call the admissions office at 819-3461110, extension 13058.
The surgeon could also opt to use a mammary
artery (inside the chest) for the bypass. In this
case, once the sternum has been opened, the
lower portion of the artery will be detached and
reconnected to your heart.
Authors
Cardiopulmonary-Care Patient Program
Surgical Patient Program
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© Centre hospitalier universitaire de Sherbrooke (CHUS)
chus.qc.ca
January 2015 – 1-6-71909