It is a question of taking a piece of vein of one himself (generally the vein safena of the calf) and of implanting it in the coronary ones skipping or the blockades. They can put themselves from one up to eight nine vein segments safena, depending on the number of blockades observed in the radiography (coronariografía) previous. The vein safena tends to do blockades similar to those of the coronary arteries. For it, there has being used more recently for the by-passes the internal mammary artery, an artery that is next to the breastbone.

From there, an end takes and the affected coronary artery takes even, beyond the blockade, leaving another end of the mammary artery where it is.

This type of solution is better that the vein graft safena for the minor tendency to do arteriosclerosis later.

The biggest surgery of the heart is done under general anesthesia, and the intervention usually lasts several hours, departs from which the function of the heart and the lungs must be assumed by a machine of extracorporeal circulation.

It appears To	Figure B	Figure C
In the figure A we can see a congested coronary artery.	In the figure B we see the implant of an artery from the aorta up to the part distal of coronary obstructed.	In the figure C we see the recovery of the blood irrigation of the coronary artery across the implant.

PROGNOSIS AND RESULTS

After the normal blood flow recovers in the coronary arteries, they usually transfer the angina or other signs of cardiovascular disease although, in fact, the underlying illness is not treated.

After the intervention, one joins the coronary unit for some days, where they go to monitor the cardiac rhythm and other vital signs to every second, at the time that feeding and medication is got for a vein.

A pipe will allow the drainage of the area of surgery.

It can be necessary to have oxygen for a mask or be connected to a mechanical respirator.

The interventions of coronary by-pass are done every day in the world and are completely sure, although as with other surgical interventions, risks exist. In general, if a normal left ventricle is had (or an acceptable pumping of the heart) and relatively good health, there is had a minor risk of 1 % of dying in the operation or in the hospitalization for surgery of coronary by pass.

The best candidates for surgery of by-pass coronary sound:

• Patients with blockade of the left coronary artery (the most important).
• Patients with illness of several glasses and bad function of the left ventricle.
• Patients with angina incapacitante.

For all these persons, the surgery of coronary by-pass is clearly useful in most cases and it prolongs the life of clear form.

TO SEE ALSO

• Cardiovascular disease. General information
• Basic tests of Diagnosis in Cardiology
• Test of Effort. Tolerance to the Exercise
• Study Isotópico
• Cardiac Cateterismo. Coronariografía
• Angina pectoris
• Coronary Angioplastia
• Infarction of Myocardium
• Infarction of Myocardium: the day later. Recovery
• The Coronary Unit
• Does the Infarction prepare the Aspirin?

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