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Bypass Surgery
What
does "bypass surgery" mean? Bypass surgery
is a surgically constructed new route around an area of blockage or narrowing
and can be performed on any artery in the body, but most often is performed
on the coronary arteries in the heart, the femoral arteries in the groin, or
the popliteal arteries behind the knee. During bypass surgery, a graft vein
or artery is taken from a healthy blood vessel in the body (sometimes an
artificial graft is used). The graft is then surgically attached above and
below an obstructed or poorly functioning artery. After surgery, the blood
will flow thru the graft vessel, avoid or "bypass" the blocked
vessel, and provide oxygen and nutrients necessary for survival to the area
of tissue beyond the blockage. Why is
the doctor performing this surgery? To bypass, or
go around, the obstruction caused by an artery filled with a clot or with
plaque (atherosclerosis). In the groin and/or legs, decreased blood flow
(therefore, decreased oxygen and nutrients) causes painful muscle cramping
and spasms, known as claudication. Claudication can progress to constant
pain, cold legs and feet, sores, and even gangrene. If the condition is not
treated adequately with medications, exercise, and quitting smoking, surgery
is necessary. What
is the surgery? Please see
Coronary Artery Bypass Surgery (CABG) for specific information about the
bypass of coronary arteries. Two other bypass vascular surgeries commonly
performed include: ·
Femoral-Popliteal Bypass - The femoral arteries in the groin,
and the popliteal arteries behind the knees, can both be areas of
atherosclerotic plaque build-up. A healthy graft vessel is taken from
elsewhere in the body (often the saphenous vein in the leg) and is attached
to the femoral artery above the narrowing. The other end is attached to the
popliteal artery behind the knee below the narrowed area. The blood will then
flow easily thru this new vessel, and avoid the plaque obstruction in the
groin. ·
Aorto-Bifemoral Bypass - If the plaque build-up is higher up
in the femoral arteries or in the iliac arteries, a different surgical bypass
is necessary. This bypass requires an artificial graft that is shaped like an
upside-down Y. The top part is attached to the aorta, and the bottom two
pieces are attached to the femoral or iliac arteries, beyond the plaque
obstruction. The blood will then flow from the aorta, into the graft, branch
into two graft conduits, then back into the patient's own femoral or iliac
arteries, and continue down the arteries of the legs. Where
is the surgery performed? In the
Operating Room (OR), under general anesthesia. How
long does this surgery take? Femoral-Popliteal
Bypass and Aorto-Bifemoral Bypass each take 2-4 hours. |
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