Name:Rooma Amin

Roll no:7986
Section:A
Semester:8th
Department:Dpt
Subject:Surgery II

1.
Your surgeon will make a cut, or incision, in the middle or side of your chest. He or she may cut through
your breastbone and spread apart your rib cage. The rib cage is opened to expose all internal organs
within your chest cavity . Your surgeon next cuts through the saclike lining that protects the heart to
access the heart itself. Your coronary arteries lie on both the front and back surfaces of the heart.
2.
The surgeon can remove a piece of healthy blood vessel from these places in the body:
The inside of your leg.Your forearm.Just behind your chest wall.These blood vessels will be used as
bypass grafts around narrowed or blocked portions of your coronary arteries.Leg and arm. While your
chest cavity is being opened, the surgeon's assistant may begin to remove, or harvest, a healthy blood
vessel from your arm or leg .
3.
Besides your saphenous vein and radial arteries, other blood vessels can be used as bypass grafts. In
fact, given that they are located close to the heart and coronary arteries, the left and right internal
mammary arteries are actually favored by many doctors. These arteries have two distinct advantages
besides their location:
4.
After your coronary arteries have been exposed and a usable blood vessel segment has been harvested,
your surgical team may place you on a heart lung bypass machine. Alternately, your surgical team may
do the operation while your heart is beating. If you are placed on the heart-lung bypass machine, your
heart will be temporarily stopped during the surgery so your surgeon can perform surgery on your
coronary arteries.
5.
Your surgeon will start to operate on the coronary arteries. The harvested vein in the sterile saline
solution is cut into appropriate lengths. Your surgeon will attach one end of the blood vessel to the aorta
and the other end onto a portion of the coronary artery past the location in the artery where there is
narrowing or blockage.In the case of the LIMA or RIMA, one end remains attached to your chest wall
and the other end is connected to the coronary artery
6.
During the surgery, blood may spill into your chest cavity as small blood vessels are cut. To prevent this
blood from interfering with surgery, a nurse or surgeon's assistant will use a suction device to suck up
the blood. The blood is then recycled back to the body. Despite this effort, though, about half of the
people who have CABG surgery end up needing a blood transfusion.
7.
If you are on the heart lung bypass machine, your doctor will restart your heart. After your bypass grafts
have been sewn in place with strong stitches , your doctor will take the clamp off of your aorta. This will
allow blood to flow to your heart, and the heart will typically start to beat again.
8
Prior to closing up your sternum, your surgeon will place several small tubes inside your chest cavity,
with one end exiting your body through an incision in your upper abdomen. These tubes allow drainage
of any extra fluids from your chest. Your surgeon will then close your rib cage and use metal wires to
bring the two halves of your sternum back together.
9.
Although the CABG procedure is considered a relatively safe procedure, it also involves certain risks. It is
important that you educate yourself about the risks of CABG surgery beforehand and talk with your
surgeon about how your current health condition will affect your risk for complications.