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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