Question: How is bypass surgery done and how long does it take?

Answer: Coronary artery bypass surgery is done for patients with coronary artery disease, and one can think of it really as fancy or sophisticated plumbing. What we do is begin by making an incision in the breast bone and sawing through that breast bone, much as you would open a three-ring binder, so to speak, and at the end of the procedure, the breast bone is rewired together, and brought back together in a sturdy manner.

But the technical aspects -- the important aspects of the surgery -- is that tubes or conduits, arteries and veins, are used to go around the blockages from upstream to downstream. This procedure does not deal with the specific blockage in the artery. It, specifically, what it does is it deals with that blockage and any future blockages that a patient might have. So, we go from upstream -- good, open blood supply -- to the more downstream side of a blood vessel using these tubes that we harvest either minimally invasively from the leg -- a vein -- or an artery that runs along a patient's chest wall.

Probably, the most important thing to know for all of us about bypass surgery is that it is the only therapy that has ever been demonstrated to prolong life expectancy for patients with multi-vessel disease or single-vessel disease who have poor heart function. So, it's critically important to understand what the indications are for this procedure.

The entire procedure, the technical aspects of sewing new blood vessels to the heart, takes usually less than an hour, but the entire operation will take three to four hours because there is preparation time, opening the patient's breastbone, and harvesting the artery and the veins from the legs, and then making sure that everything is closed up properly at the end of the procedure.

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