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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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