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By Mayo Clinic staffYou and your doctor can consider whether coronary bypass surgery or another artery-opening procedure, such as angioplasty or stenting, is right for you.
Coronary bypass surgery is an option if:
- You have severe chest pain caused by narrowing of several of the arteries that supply your heart muscle, leaving the muscle short of blood during even light exercise or at rest. Sometimes angioplasty and stenting will help, but for some types of blockages, coronary bypass surgery may be the best option.
- You have more than one diseased coronary artery and the heart's main pump — the left ventricle — is not functioning well.
- Your left main coronary artery is severely narrowed or blocked. This artery supplies most of the blood to the left ventricle.
- You have an artery blockage for which angioplasty isn't appropriate, you've had a previous angioplasty or stent placement that hasn't been successful, or you've had stent placement but the artery has narrowed again (restenosis).
Coronary bypass surgery may also be performed in emergency situations, such as a heart attack, if your doctor sees that you're not responding to other treatments.
Coronary bypass surgery doesn't cure the underlying heart disease that caused blockages in the first place. This disease is referred to as atherosclerosis or coronary artery disease. Even if you have coronary bypass surgery, lifestyle changes are still a necessary part of treatment after surgery. Medications are routine after coronary bypass surgery to lower your blood cholesterol, reduce the risk of developing a blood clot and help your heart function as well as possible.
- Eagle KA, et al. ACC/AHA 2004 guideline update for coronary artery bypass graft surgery: Summary article — A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2004;110:1168.
- Bypass surgery, coronary artery. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4484. Accessed May 11, 2010.
- Shapira OM, et al. Coronary artery bypass graft surgery after acute ST elevation myocardial infraction. http://www.uptodate.com/index. Accessed May 11, 2010.
- Aranki S, et al. Early cardiac complications after coronary artery bypass surgery. http://www.uptodate.com/home/index.html. Accessed May 11, 2010.
- Aranki S, et al. Early noncardiac complications after coronary artery bypass surgery. http://www.uptodate.com/home/index.html. Accessed May 11, 2010.
- Holzhey DM, et al. Seven-year follow-up after minimally invasive direct coronary artery bypass: Experience with more than 1300 patients. The Annals of Thoracic Surgery. 2007;83:104.
- Suaya JA, et al. Use of cardiac rehabilitation by Medicare beneficiaries after myocardial infarction or coronary bypass surgery. Circulation. 2007;116:1653.
- Puskas JD, et al. Off-pump coronary bypass provides reduced mortality and morbidity and equivalent 10-year survival. The Annals of Thoracic Surgery. 2008;86:1139.
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