What is bypass surgery: How it works and the risks – Insider – INSIDER

Bypass surgery, also known as coronary artery bypass grafting, is one of the most common operations worldwide. In the US, there are approximately 200,000 bypass surgeries each year, according to the Journal of Thoracic Disease.

Here's what you need to know about what bypass surgery entails and who might need this procedure.

Bypass surgery redirects blood vessels around blockages

Doctors typically conduct bypass surgery on patients with blockages in one or more of their coronary arteries, thus prohibiting adequate blood flow to the heart. If left untreated, coronary artery blockages can lead to a heart attack.

To perform the procedure, a surgeon takes healthy blood vessels from another part of your body and connects them beyond the blocked arteries, therefore bypassing the blockage and improving oxygenated blood flow to your heart.

Bypass surgery is often necessary for those with coronary artery disease, says Dr. Nahush Mokadam, a cardiac surgeon at the Ohio State University Wexner Medical Center.

Modifiable risk factors for coronary artery disease include tobacco use, high cholesterol, diabetes, and high blood pressure. These conditions can all contribute to plaque build-up in your blood vessels and cause blockages, Mokadam says.

If plaque-build up becomes severe enough to block one or more coronary arteries, you may experience chest pain, shortness of breath, fatigue, or even a heart attack. Your doctor might suggest coronary bypass surgery if blockages show up on an angiogram or x-ray of the heart, or if you've already experienced a heart attack.

What happens during bypass surgery

Bypass surgery is a type of open-heart surgery that requires general anesthesia and can last anywhere from three to six hours. The heart is typically stopped during the procedure and attached to a heart-lung machine that mechanically circulates blood during the operation.

The most commonly used blood vessel to reroute the flow of blood around a blockage is called the left internal mammary artery, which runs under the rib cage and is close to the heart and coronary arteries, Mokadam says. Other blood vessels used for bypass surgery include the right internal mammary artery, the radial artery, or the saphenous vein from the thigh.

Bypass surgery is mostly effective and safe

Bypass surgery has shown to be the most effective at restoring adequate blood flow to the heart and decreasing symptoms of chest pain in patients with multiple artery blockages, those with type 1 or type 2 diabetes, and patients who have suffered heart damage, Mokadam says.

In a 2016 study of 1,212 patients, researchers found that bypass surgery in addition to medical therapy led to significantly lower rates of death and hospitalization over a 10-year period among patients with coronary artery disease, heart failure, and left ventricular dysfunction compared to those who received only medical therapy.

There are some risks associated with the procedure, including infection and stroke, with an increased risk of complications if you have another condition, like kidney disease, or if the bypass surgery is done as an emergency procedure.

The mortality rate for bypass surgery 2% to 3% and the complication rate is 20% to 30%. "This is an operation on the heart, so patients should give this the gravity that it deserves," Mokadam says.

To read more about preparing for a smooth procedure, read our article, "How to prepare for bypass surgery."

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What is bypass surgery: How it works and the risks - Insider - INSIDER