Your cardiologist may refer you to Dr Scott with the suggestion to have a coronary artery bypass grafting. A coronary artery bypass graft is done to bypass the diseased or blocked artery in order to aid blood flow to and from the heart and prevent the risk of having a heart attack. Dr Scott is particularly experienced in placing these grafts for a number of patients.

Why would a coronary artery bypass graft be needed?

A coronary artery bypass graft or stent placement is done for diseased and blocked coronary arteries, most likely caused by coronary artery disease and cholesterol. People with these conditions sub-sequentially may suffer from diabetes or hypertension which may further damage coronary arteries. After diagnostic procedures such as angiogram, your cardiologist may suggest a coronary artery bypass graft instead of a stent if:

  • two or more coronary arteries are blocked
  • the blockage or damage to the artery is severe
  • the previous stents have failed
  • the artery cannot be accessed with a stent
  • the section of the artery is too long to treat with a stent
  • For these reasons, your cardiologist may refer you to a cardiothoracic specialist.

When coronary arteries are blocked or narrowed, the oxygenated blood flow to the heart is restricted, meaning the heart does not receive sufficient oxygen. Restricted amounts of oxygen to the heart may cause angina, severe chest pain and when a total blockage occurs, a heart attack may occur causing permanent damage to heart muscle.

How is this procedure done?

Surgery will depend on the severity of the blockage and the number of arteries that appear blocked. Under general anaesthesia, Dr Scott will open the chest cavity and remove the damaged arteries. He will then administer anti-clogging medications as well as connect the patient to the machine to take over the job of both the heart and lungs in supplying the body with oxygen-rich blood. He will then give you medications to stop your heart beat so that he may work on a still heart to complete the grafting. You will be given medication to protect the heart muscle while the heart is stopped.

Your cardiothoracic surgeon will take an artery from the chest or a vein from leg to use as a bypass graft to repair the damaged clogged coronary artery. Because arteries are less likely than veins to become blocked, an artery graft from the chest is more typically used. Once your cardiothoracic surgeon has completed the grafting, he will restore the blood flow to your heart. Doing this usually should restart the heart, if it doesn’t restart on its own, he may use a mild electric shock to restart the heart’s beating. He will then proceed to remove you off the heart-lung bypass machine, close the chest with stitches and place a draining tube for recovery.

What can I expect after surgery?

Waking up from surgery, you can expect a chest tube to be placed in your chest to drain any blood or fluid that may build up in the chest. You should have a catheter placed for urine for the next few days before you can get up and move around. You will be kept in the ICU for close observation of your heart, blood flow and fluid drainage for about 2 days. You will be advised by your doctor whether or not a pacemaker may be needed temporarily while you recover. On a daily basis, you will receive oxygen therapy and be given compression stockings to wear on your legs as well. You will be moved from ICU to your hospital room where you will be advised to stay for a further 3 to 5 days before you may go home.

Dr Scott will advise you on how to care for your incisions and how to treat the symptoms after surgery. Symptoms of swelling, muscle pain in the upper back and shoulders, fatigue, sleeping and appetite problems, constipation and chest pain near the chest bone are all normal after coronary artery bypass grafting surgery. It may take anything from 6-12 weeks for a full recovery, and he will be able to tell you when you may return to physical activity. Patients are usually able to return to work at 6 weeks post-operation depending on the physical demand of their type of work.