During Bypass Surgery The Doctor Takes Vessels From Other Parts Of My Body. Don't I Need Those?

Question: During bypass surgery, the doctor takes vessels from other parts of my body. Don't I need those?

Answer: Well, you know, it is true that when you do a simple bypass operation, you're taking healthy blood vessels from one part of your body and putting them in your heart to maintain the heart function, which is good for your heart but could be bad for those other places in your body which are being robbed of the blood vessel.

Not necessarily the case, it turns out, because unlike your heart, which has a limited ability to figure out what to do when you've got a blocked vessel, or absent vessel, other places in your body can figure that out pretty well.

The vessels we use primarily are the internal mammary arteries in your chest, which run along the inside of your breastbone, inside the ribs. It's just the right size to implant in a blood vessel in your heart.

God invented that just right; and God was very kind because that blood vessel doesn't go very far, and it's not really important, because of other blood vessels in your chest wall that can take over the circulation that's being missed when you remove that blood vessel and put it in the heart instead.

If you use the saphenous vein from your leg, there we have the advantage that this is a vein, not an artery. This is taking blood returning from your leg back to your heart. We've got lots of them, and to remove a vein initially causes a problem; it causes swelling because there's fluid in your leg that doesn't return to your heart normally.

So most patients after a bypass operation, if we use the leg veins, the saphenous veins, there is some swelling afterward. But with time, your legs figure out what to do; it's like you're stuck in Chicago on Michigan avenue and you can't get down into the loop and so you go and take an alternate route and find a different way to get there. And your legs figure that out also, by taking an alternate route. Some of those other veins will grow with time and be able to handle more blood flow.

Occasionally, surgeons also use the radial artery, which is the small artery where you can feel your pulse in your wrist; we only do that if there's good flow in the other artery, the ulna artery, on the other side of your wrist.

And we can do a test to be sure that there's good enough blood flow from that other artery, that it's safe to take the radial artery -- because you have two ways of getting blood flow into your hand and it's safe to take the radial artery out, as long as there's good blood flow to the other blood vessel. So mother nature is kind here, we don't lose much with a bypass operation.

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