During the bypass surgery, you can expect to be treated by a group of experts, which includes a cardiothoracic surgeon who will perform the surgery. In addition, there will be a physician assistant, anesthesiologist, perfusionist, nurses, and other surgeons. The process will depend on whether you are undergoing on-pump bypass surgery or off-pump.
On-Pump Bypass Surgery
This surgery type will take three to four hours or more, depending on how many arteries doctors treat.
At first, the doctors will give you anaesthesia to put you to sleep. During this time, an anesthesiologist will record your heartbeat on the monitor along with oxygen level, blood pressure and breathing rhythm. He or she will place a breathing tube and connect your lungs to a ventilator.
Next, the doctors will make an incision at the centre of your chest to open your ribcage so that surgeons can operate on your heart. Meanwhile, you will be given some medicines to enable surgeons to perform the surgery while your heart is not beating.
In this surgery, the doctors take a vein or an artery from a different part of your body, like the leg or chest and prepare it to use as a graft. However, if several bypasses need to be done, they may use several combinations of arteries and vein grafts. After the process is successful, doctors start your heart using a mild electric shock.
Lastly, the doctors disconnect the heart-lung machine from your chest and insert tubes to drain fluids.
Surgeons also use wires that stay in your chest permanently to keep the chest bone close. Also, they close the skin incision using staples and stitches. Finally, they remove the breathing tube after ensuring you can breathe independently.
Off-Pump Bypass Surgery
This is a beating heart CABG surgery to bypass any coronary artery. Here, instead of using a heart-lung machine, the surgeons perform grafting using a mechanical device to steady your heart.
It reduces complications in operation and is often helpful for those patients who already have a history of mini-strokes, have crossed the age of 70, have kidney disease, have lung disease or have diabetes.