M At The Doctor

Coronary bypass surgery: bypass or stent?

Generally, in cardiology, in case of angina pectoris or infarction requiring intervention on one or more coronary arteries, it is preferred in the first place performing angioplasty with the installation of a stent.

But sometimes, the artery is too damaged or stent by angioplasty is not appropriate, this is why we propose a coronary bypass.

The solution of coronary bypass surgery

To deliver oxygen to the heart muscle (myocardium) that suffers, the obstacle must be circumvented by making a bypass or "bridge": the coronary bypass (or cardiac).

A segment of the vessel (graft) is taken from the leg (saphenous vein), the arm (radial artery), or from the thorax (mammary artery). One end of this vessel segment is placed at the level of the aorta (from which the coronaries are normally born) and the other end downstream of the blocked site. Result: the blood comes back to the heart by this bridge and does not pass by the obstructed way. Bridging may involve several coronary arteries, it is called triple or quadruple bypass.

How is the operation?

You must make an appointment a few days before for a blood test, an electrocardiogram, an echography of the heart and carotid arteries, a visit with the anesthesiologist and answer a health questionnaire. Hospitalization is often done the day before.

Stopping smoking, if only for the 15 days preceding the operation, already decreases the risk of pulmonary or scarring complications. The operation is done under general anesthesia. The incision measures 10 to 15 cm long and is located opposite the sternum. To perform the bypass, the heart is most often stopped but the blood circulation is maintained through a heart-lung machine (extracorporeal circulation).

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Read also :

> 10 scientific facts to know about the heart
> Heart rhythm disorders

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