Coronary Artery Bypass Lab Report

1. Procedure

Coronary Artery Bypass Graft (CABG) is performed when a patient has disease of the coronary arteries. This is usually caused by atherosclerosis which is clogging of the arteries or hardening by cholesterol of plaque. Coronary Artery Bypass is done to improve the blood flow of the heart. The surgeon bypasses the obstructed artery using a healthy artery that is harvested from another part of the body and placed in the heart to reroute the blood flow around the blocked area. Usually the healthy vein is taken from the patients leg or arm using a procedure called Endoscopic Saphenous vein harvest. To begin the Bypass graft the surgeon makes an incision in the middle of the chest, After the incision is made Sternotomy is performed. The Surgeon saws through the breastbone. Tubes are then inserted into the right atrium to passage blood out of the body through a lung heart machine. The outcome of this surgery is usually excellent.
The heart is a four-chamber organ that pumps blood throughout the body.
There are two upper chambers of the heart and they are called the atria. These chambers obtain and collect the blood. The left atrium gathers the flow of oxygenated blood that goes back to the heart. The right atrium receives deoxygenated blood through the inferior and superior vena cava. The right side of the heart pumps the deoxygenated blood in the pulmonary veins around the lungs. The two inferior chambers of the heart are called ventricles. The ventricles pump blood beyond your heart to all parts of the body. In a healthy working heart the right atrium, pumps blood into the right ventricle. From the right ventricle, blood is pumped to your lungs throughout the pulmonary
arteries.

2. Post Op Complications

There are several Post Op complications that may follow Coronary Artery Bypass Graft Surgery Including death at 3-20% of overall surgery’s. The risk of death strikes more frequently in patients older then 65 years or age, in females, and in emergency surgery circumstances. Some other post op complications are Respiratory failure (which includes Atelectasis, Pleural effusion, and ARDS), Pulmonary hypertension, Myocardial dysfunction (Cardiac tamponade, CABG graft ischemia), Vasoplagia , Neurological Complications including Focal neurological deficit and impairment of memory or cognition, Renal failure requiring dialysis, Hyperglycemia, Coagulopathy, and Mediastina’s. Furthermore, Bleeding, infection, and heart attacks have been seen in patients following bypass surgery.

3. Surgical procedures observed

a. Coronary Artery Bypass Graft Surgery

This surgery is done to improve blood flow to the heart. Usually in patients with severe heart disease. Surgery is done under general anesthesia. This surgery is invasive and requires several team members to assist. Some including, Anesthesiologist, first assistant, surgical technician, circulating registered nurse, CRNA, and often a perfusionist. Surgery is performed to improve blood flow to the heart using a healthy vein. The healthy vein is inserted into heart where the vein bypasses the obstructed vein.

b. Wedge resection of the left lung

A wedge resection sometimes called a lung biopsy is performed to remove a slice of tissue. The tissue is normally a tumor suspected to be cancer, nodules, masses, or spots. The specimen is then sent for analysis and observation performed usually by a pathologist.

c. Endoscopic Saphenous Vein harvest
This is a minimally invasive procedure commonly used in a patient undergoing coronary bypass surgery. The Surgeon or first assistant removes a healthy Saphenous Vein by cautiously cutting and closing off smaller blood vessels that divide off the main vessel. This vein in then used for Bypass of an obstructed vessel during Coronary Artery Bypass surgery