Conventional On Pump Coronary Artery Bypass Surgery
More than 70% of all bypass surgeries are performed on a stopped heart. Unlike beating heart surgery, during conventional on pump heart bypass, medication is used to stop your heart.
A heart-lung machine takes over the function of your heart and lungs during the surgery.The heart-lung machine is also called a cardiopulmonary bypass machine. It has a pump to function as the heart and a membrane oxygenator to function as the lungs.
A patient is placed on cardiopulmonary bypass (the heart lung machine) during conventional open heart surgery. The advanced heart-lung machine, takes over the job of keeping oxygen-rich blood circulating throughout the body during conventional CABG surgery. This allows the surgeon to perform the surgery on a still heart.
Heart-Lung Machine
This mechanical "heart and lungs" keeps oxygen rich blood circulating throughout your body. The heart-lung machine collects the blood. Carbon dioxide and other waste products are removed. The oxygenator adds oxygen, and the oxygenator's heat exchanger warms (or cools) the blood. The blood is gently circulated back through the body. This process is called perfusion. The person who operates the heart-lung machine is the perfusionist.
Stopping Your Heart
Your heart will usually be stopped for about 30-90 minutes of the 3-6 hour surgery. The heart-lung machine makes it possible for the surgeon to work on a still heart. This technique has been used for many years with excellent results. Once the surgery is over, the surgeon and perfusionist restart your heart.
On Pump Coronary Bypass Surgery :
Coronary artery bypass grafting, or "CABG" (pronounced "cabbage"), is a common heart procedure. A surgeon takes a section of a healthy blood vessel from your leg, chest, or arm. The vessel is then connected (grafted) to your coronary artery slightly past the site of the blockage. This creates a new path for blood to flow around (bypass) the blockage in the artery so it can get to your heart. Patients undergoing bypass are put under general anesthetic and are not awake during surgery.
A team of surgeons performs coronary artery bypass surgery. The operation takes 3 to 6 hours, depending on how many blood vessels need to be bypassed. One cut (incision) is made in the center of the chest at the breastbone to allow the surgeon to see the heart and for detaching an artery in the chest, called the internal mammary artery, for doing the bypass surgery. Another incision may be made in your leg to remove a vein that will be put in your chest and another cut made on left hand to remove radial artery, conduit used for bypass surgery. The patient is then connected to a heart-lung machine that supplies oxygen to blood and circulates it back into body while the surgery is performed.
If a vein is used for the bypass, one end of it is sewn into the aorta (the main artery from the heart to the body). The other end is sewn into the area below the blockage in the coronary artery. If the mammary artery is used, the lower end of the mammary artery is cut and reattached to the coronary artery beyond the blockage. In either case, the blood then uses the new vessel as a detour to bypass the blockage.
When the surgery is finished, heart-lung machine is disconnected, breastbone is closed with wire, and skin is closed with stitches.
