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When blood is unable to flow easily through the arteries of your heart, you may need to undergo coronary artery bypass surgery. Your doctor recommends heart surgery when the pain or other symptoms are not manageable by medications and life style changes alone. Or, you may have critical narrowing in vessels that diminish the blood flow to a large portion of the heart muscle, placing you at risk for a disabling heart attack.
The surgeon must bypass the obstruction in the artery since it cannot be dissolved or removed. Bypassing the blockages will supply the necessary oxygen, thereby relieving angina and increasing the function of the heart.
The blockages in the coronary artery are not removed but will be bypassed using the saphenous vein from the leg and/or the internal mammary artery from the chest. The saphaneous vein is removed from the leg and one end of the saphenous vein graft is sewn to the largest artery in the body (aorta) and the other end is sewn past the obstruction into the coronary artery. The internal mammary artery is freed at one end in the chest and sewn past the obstruction into the coronary artery. Either graft reroutes the flow of oxygen-rich blood to the heart muscle. These procedures can be compared to a road detour.
If you have a stent in place in the vessels bypassed, the stents are not removed.
Removing the internal mammary artery for use in the heart's circulation has not been shown to cause any injury to the chest muscles. Some patients may experience numbness of the chest that lessens with time but may not disappear entirely.
Removal of the saphenous vein will not hinder normal circulation in the leg(s). The blood that previously flowed through the saphenous vein will change its course of travel. This is known as "collateral circulation.” Following surgery, there may be some swelling in your leg(s) but this will decrease in time.