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Introduction to Coronary Artery Bypass Surgery
  
Before talking about Coronary Artery
Bypass Surgery, we need to talk about the blood supply to the heart:
The heart is busy pumping blood out to the rest of the body and
it does so through a very large artery leading out of the heart known as the
aorta (see diagram above). Keep in mind, even though the heart is
pumping blood out to all the other organs, the heart needs its own blood supply
in order to survive. The blood supply to the heart comes from the
coronary arteries, which are actually the first two branches of the
aorta.
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What is hardening of the arteries?
The fancy word for hardening of the arteries is
atherosclerosis. Basically, the inner lining
of the coronary arteries becomes damaged and as a result plaque (fatty
substances and calcium) begins to build up. As the plaque builds up,
the arteries become narrowed as shown in the picture below:
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What causes hardening of the
arteries?
There are many common risk factors that leads to hardening of the arteries.
Unfortunately, the most common is
genetics. If your parents had coronary artery
disease, especially at a young age, then your risk for coronary artery disease
is also high. Keep in mind, if your parents did not have coronary artery
disease that does not mean you're free and clear. Our genetics go back
thousands of years and so the bad genes can be hidden for generations.
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After genetics, there is a whole list of other risk factors. Of
course, some might debate that all of the following are effected by genetics
as well. For example, everyone agrees that
high cholesterol is a risk factor for heart
disease. Certainly, our diets have an impact on our cholesterol
levels, but also our genetics determine our baseline cholesterol levels.
That's not to say that you should continue to eat fried foods because your
family has a history of high cholesterol. On the contrary, it's even
more important for you to stop eating high fat foods since your risk for
getting heart disease is even greater. |
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High blood pressure (arterial hypertension) is
one of the most common risk factors for developing hardening of the
arteries. In addition, high blood pressure causes muscle damage to the
heart, leads to aneurysm formation, kidney failure, and even stroke. The
problem with high blood pressure is that most patients don't realize that
they have it. It's truly a silent killer! That's why you need to have a
yearly physical exam. Interestingly, high blood pressure can often be
tricky to treat as patients may exhibit "normal" blood pressure in their
doctor's office, but have an abnormal response in blood pressure during
exercise or stress. |
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Diabetes
causes hardening of the arteries. Indeed, diabetes causes very severe
changes in all of the body's blood vessels, nerves, and tissues. When the
diabetes is severe, the blood vessels can become so narrowed and diseased
along their lengths that we can't even perform a bypass to the vessels
because their is no adequate place to do our sewing.
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Obesity
can lead to diabetes and, of course, can contribute to high cholesterol and
high blood pressure. As you can imagine, it's very common for us to see
patients with multiple risk factors. Additionally, patients with both
diabetes and obesity are at significant risk for developing wound infections
and difficulty healing. |
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Smoking
causes hardening of the arteries. Yes it does! Cigarette smoke is
toxic for many reasons. First, it causes spasm of the the blood
vessels. On top of that, the chemicals in the smoke include chemicals
that break down tissues and destroys the cells throughout the body.
That's why smokers are at risk for a lovely combination of heart disease
and cancer. By the way, not just lung cancer, but many others such as
kidney cancer, blood cancer, and blood cancers. Heavy smokers also do
poorly with surgery, often having pulmonary (lung) complications such as
pneumonia, blood clots, and a significantly increased chance of wound
problems. |
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Last Modified
Monday, January 03, 2011
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