Coronary artery disease, Coronary artery bypass

Chest | - Others | Coronary artery disease, Coronary artery bypass (Disease)


Coronary artery disease develops when your coronary arteries - the major blood vessels that supply your heart with blood, oxygen and nutrients - become damaged or diseased. Cholesterol-containing deposits (plaque) on your arteries are usually to blame for coronary artery disease.

Coronary Artery Bypass is a surgical procedure where a blood vessel, usually taken from the leg or chest, is grafted onto a blocked artery of the heart, bypassing the blockage and restoring blood flow. It can be done on one or multiple arteries. By restoring blood flow to the heart, it can prevent heart attacks.

Causes and Risk factors

With coronary artery disease, plaque first grows in the coronary arteries until the blood flow to the heart’s muscle is limited. This is also called ischemia. It may be chronic, caused by narrowing of the coronary artery and limitation of the blood supply to part of the muscle. Or it can be acute, resulting from a sudden plaque that ruptures.

The traditional risk factors for coronary artery disease are high LDL cholesterol, low HDL cholesterol, high blood pressure, family history, diabetes, smoking, being post-menopausal for women and being older than 45 for men. Obesity may also be a risk factor.

Diagnosis and treatment

One way to treat the blocked or narrowed arteries is to bypass the blocked portion of the coronary artery with another piece of blood vessel. Blood vessels, or grafts, used for the bypass procedure may be pieces of a vein taken from the legs or an artery in the chest. One end of the graft is attached above the blockage and the other end is attached below the blockage. Thus, the blood is rerouted around, or bypasses, the blockage through the new graft to reach the heart muscle. This bypass of the blocked coronary artery can be done by performing coronary artery bypass surgery.

Traditionally, in order to bypass the blocked coronary artery in this manner, the chest is opened in the operating room and the heart is stopped for a time so that the surgeon can perform the bypass. In order to open the chest, the breastbone (sternum) is cut in half and spread apart. Once the heart is exposed, tubes are inserted into the heart so that the blood can be pumped through the body during the surgery by a cardiopulmonary bypass machine (heart-lung machine). The bypass machine is necessary to pump blood while the heart is stopped and kept still in order for the surgeon to perform the bypass operation. ...

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