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Coronary Artery Bypass Graft (CABG) Surgery – PreOp® Patient Education

Coronary Artery Bypass Graft (CABG) Surgery – PreOp® Patient Education

your doctor has recommended an on pump
coronary artery bypass graft procedure also called cabbage before we talk about
this procedure let’s review some information about your body and your
medical condition the heart is in the middle of the chest under the ribs it is
protected by the sternum also called the breastbone the heart is a muscle that
pumps blood to all parts of the body through blood vessels called arteries
veins are vessels that carry blood back to the heart the aorta is the largest
artery in the body to vessels that branch off from the aorta are the right
and left coronary arteries they supply the heart muscle with the oxygen-rich
blood that is necessary to keep it working
coronary arteries can become blocked by plaque fat and calcium deposits that
build up over years the result is coronary artery disease also called
heart disease severe blockages caused chest pain heart attacks and sometimes
death during a cabbage procedure new pathways called bypasses are put in
place to carry blood past and around blockages healthier blood vessels from
other sites in the body are used to create each bypass a section of leg vein
or piece of an artery from an arm may be removed and used to create the bypass
these transplanted vessels are called grafts the right and left internal
thoracic artery ZAR also commonly used as grafts these arteries naturally pass
close to the heart when creating a bypass with one of these vessels often
only one end of the vessel is moved to the coronary artery past the blockage when arteries or veins are moved or
removed from one body part to another this is possible only when there will
still be enough blood supplied from other nearby vessels there are different
surgical techniques for coronary artery bypass on pump and off pump during the
several hours it takes to do an on pump cabbage surgery the heart is stopped for
about 30 to 90 minutes this keeps the heart muscle still while the surgeon
says vessels into place to create the necessary bypasses while the heart is
stopped a special pump called a heart-lung machine keeps blood
oxygenated and flowing through the body blood is carried from the body through
tubing to a machine where it is mixed with oxygen then pumped back to the body
after all of the grafts have been placed the heart is restarted and the pump is
disconnected in some situations a less invasive cabbage procedure may be
offered this can include an off pump technique where the heart is not stopped
in some cases smaller incisions may be used during these procedures converting
to an on pump procedure is still possible individual surgical treatment
decisions depend on many factors including the experience of the surgeon
how many arteries are involved the location of the blockages and their
severity now let’s look closer at the on pump coronary artery bypass surgery you
will be given medication to be pain-free and asleep during this procedure the
necessary grafts are created by surgically removing sections of blood
vessel from the leg and/or arm as needed these incisions are sutured and bandaged
to reach the heart the surgeon makes an incision down the center of the chest
the sternum bone is carefully cut a retractor is then placed to hold the
edges apart creating a working area the protective sac that surrounds the heart
called the pericardium is opened the surgeon inspects the heart and
identifies the vessels to be bypassed the heart-lung machine is prepared by
connecting tubing to the heart and vessels as appropriate for each
situation when the pump is primed and the grafts are ready for placement the
heart-lung machine is turned on the heart is cooled and the aorta is able to
be clamped blood flow through the heart and motion of the heart stops the
surgeon then stitches the intended grafts into place depending on the
number of blockages connections to one or both internal thoracic artery x’ may
be used to complete the necessary bypasses the clamp is removed from the
aorta once the heart is beating normally the heart-lung machine is disconnected
and the tubing sites are repaired the pericardium is positioned back over the
heart flexible drains are placed and the sternum is closed and supported with
wire or small plates and screws the remaining tissue layers are brought
together the skin is closed and a dressing is placed

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