With over 500,000
operations performed each year, Coronary Artery Bypass Graft (CABG) is one of
the most common surgeries in the United States. As your coronary arteries get
blocked, your physician may suggest treating the problem by making a new
pathway for blood to reach the heart muscle. Therefore, a blood vessel is
either removed or redirected from one area & placed around the area to
“bypass” the blockage in order to restore normal blood flow.
Arteries Normally Used for CABG
Substitute blood vessels
can either come from chest, arms or legs. Arteries within these areas are safer
as there are other pathways supplying blood to the tissues. However, the
surgeon would eventually decide on which graft to be used depending upon the amount
& location of the blockage & size of the coronary artery.
Internal Mammary Arteries:
These are one of the most
common bypass grafts used for CABG & which have proven to deliver best
long-term results. Moreover, as they have self contained oxygen-rich blood
supply can also be kept intact at their origin. The surgical procedure is also
simpler. One end of the artery is sewn to coronary artery below the blockage
site. Since the graft artery is also located in the chest, it can be accessed
through the primary incision made for CABG.
Radial Arteries:
There are two arteries
located in the lower part of the arm, namely Ulnar & Radial artery. Ulnar
artery alone is good enough to provide adequate blood flow to the arms. If the Radial
artery is removed to be used as graft, it will not have any side effects.
Preoperative & intra-operative tests will only be able to determine if the
Radial artery can come useful. However, if the patient is suffering from
conditions like Raynaud’s, painful fingers in cold air or carpal tunnel
syndrome, this type of graft may not be a good idea to access.
Saphenous Veins:
Saphenous veins are
removed from the leg & then sewn from aorta to coronary artery below the
site of blockage. Saphenous vein removal is minimally invasive thus resulting
in less scarring & faster recovery.
Gastroepiploic artery to
stomach & epigastric artery to abdominal wall are also used in CABG,
although rarely. Three or four coronary arteries bypassed during surgery is a
common practice. CABG can be performed with minimally invasive or traditional
surgery. The surgeon will review diagnostic tests prior to surgery & decide
if you are a good candidate for minimally invasive bypass surgery.
