A leg bypass surgery is actually an incorrect appellation for a Coronary Artery Bypass Graft or CABG. This is a procedure that is performed when a patient suffers from angina. Angina is a reduction of oxygen and nutrients to the muscles of the heart due an occlusion in the arteries that supply blood to the heart. This is usually caused by atherosclerosis, a buildup of cholesterol plaques in the coronary arteries until the artery becomes completely sealed off. The surgical cure for this problem, once administration of drugs like statins have failed, is to reroute the blood flow to the heart. This procedure requires a replacement blood vessel and one of the vessels that are used for this purpose is called the saphenous vein from the leg – and therefore the appellation of a leg bypass surgery.
The procedure is long and involves stopping the heart, to work on it and then restarting the heart. The procedure begins with heavy anesthetization and performing a sternotomy – opening up the sternum to gain access to the heart. The heart is then located and a detailed inspection is conducted on the heart. The blood flow to the heart muscles can usually be checked with using another non-surgical procedure called an angiography; however, the exact number of grafts required can only be ascertained once the heart is accessed through surgery. The surgeon will then identify the number of grafts that are required. This is the origin of the term double and triple bypass. It indicates the number of grafts and reroutings that a surgeon needs to perform. Once the bypasses are chalked out, the blood vessels are harvested and an anticoagulant called heparin is administered. Being an extremely long procedure, the last thing that a surgeon would want to deal with is clotting of blood at this time.
The grafted veins are then prepared by removing the one-way flow valves and smoothened out from inside. The grafts are then sewn from the aorta to the required piece of muscle. This procedure works best with arteries on the surface of the heart and not those vessels within the heart muscle. While the graft is underway, the heart is stopped and a heart –lung machine keeps the patient alive. After the surgery is complete, the heart is restarted and a coagulating factor and antidote to heparin is given. The patient is then sewed up and sent to the ICU to recover.