What is Bypass Surgery?
Coronary Artery Bypass Grafting (CABG), commonly known as ‘Bypass Surgery’, is a surgery that improves blood flow to the heart. CABG is the most recommended treatment for coronary artery disease. During a CABG surgery, your surgeon takes grafts from other parts of the body to go around or ‘BYPASS’ these blocked or narrowed coronary arteries.
Which grafts are best for bypass surgery?
The choice of bypass graft depends on :
- Location of the block
- Extent of the block
- Size of the coronary arteries
- Availability of arteries and veins
- Patient medical factors
What are the different types of grafts used in a bypass surgery?
- Arterial Grafts:
Internal Thoracic Arteries (ITA): ITA grafts are also known as Internal Mammary Arteries (IMA). ITA is the most commonly used bypass grafts because they yield good results in the long-term. We have two ITA in the chest. If these arteries are used as a bypass, they can be kept intact at their original position because they already have their own oxygen-rich blood supply. The other end is cut and sewn to the coronary artery below the block. Surgeons tend to use these arteries for every patient who is undergoing a bypass surgery.
The Radial Artery (RA): RA is another common type of arterial graft. There are two arteries in the arm – the ulnar and radial arteries. The ulnar artery delivers blood to the arm, so most people won’t have any side effects if the radial artery is used as a graft. If the radial artery is used as the graft, the patient may need to take a calcium channel blocker medication for several months after surgery. This medication helps to keep the artery open. This type of graft is known to have good results, although long-term outcomes are not fully known.
Other less commonly used arteries are the gastroepiploic artery, which is a branch leading to the stomach, and the inferior epigastric artery, which leads to the abdominal wall. These arteries are more difficult to use but can be a good option if other arteries cannot be used.
- Vein Grafts
Saphenous Veins (SPV): SPV is a commonly used vein for bypass due to its ease of harvest. SPV is the longest vein in the human body, extending from the top of the foot to the upper thigh and groin. Vein grafts tend to fail in the long term.
Dr Mahadevan Ramachandran, a cardiac surgeon with over 15 years of independent experience in the premier hospitals of Kerala. He is currently working as Chief Consultant Cardiac Surgeon at the following hospitals:
Total Cardiac Care, Thiruvananthapuram
Cosmopolitan Hospital, Thiruvananthapuram
Azeezia Medical College, Kollam
NIMS Medicity, Neyyantinkara
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Read in Malayalam: ബൈപാസ് ശസ്ത്രക്രിയയ്ക്ക് എന്ത് തരം ഗ്രാഫ്ടുകള് ഉപയോഗിക്കാം?
