CoronaryConcerning the coronary vessels that supply blood to the heart muscle. heart disease

Coronary heart disease is the most common cause of death in industrialised countries. In Germany alone, there are about 6 million people affected, of whom about 300,000 suffer a heart attack every year. The heart muscle is supplied with oxygen-rich blood via the coronary vessels (coronaries). If constriction occurs due to deposits in these vessels, the subsequent heart muscle is no longer supplied with sufficient blood. If the blood flow is throttled by the constriction to such an extent that heart muscle cells die, this is called a heart attack.

Coronary bypassA vascular bridge. A bypass is used to circumvent narrowed sections of blood vessels. This allows organs to be supplied with sufficient blood again, for example. surgery

Coronary bypass surgery bridges the narrowing via a bypass circuit so that the following heart muscle can also be supplied with blood again. The bypass vessels are largely made with arterial connections, which have a much more favourable prognosisPrediction about the course and outcome of a certain disease made by a doctor on the basis of the circumstances and/or examination results. than venous bridges. Arterial connections are made through chest wall arteries (mammary arteryA blood vessel leading away from the heart that transports oxygenated blood to the organs. Arteries pulsate and can be palpated on the wrist, for example (pulse). The aorta is the main artery of the body.); venous bridges use veinsBlood vessels through which the deoxygenated blood flows back from the organs to the heart. The flow retains its direction to the heart through valve-like venous valves. from the leg.

According to the European guidelines, coronary bypass surgery is recommended in cases of narrowing of several coronary vesselsCoronary arteries. The left and right coronary arteries originate above the aortic valve from the aortic root and initially run along the outside of the heart muscle before branching out into many sub-branches and dipping into the heart muscle tissue as fine arterioles., especially in patients with diabetesSee Diabetes mellitus. mellitus. In addition, narrowings that are difficult to access for stents can be treated by bypasses. Since the arterial connections with the chest wall arteries have a more favourable prognosis, total arterial bypass grafting is the preferred option, especially in patients under 70 years of age.

Bypass surgery is performed using the heart-lung machineEquipment that takes over the work of the lungs and the stopped heart during heart surgery. The blood is directed from the vena cavae and thus out of the body into the machine, where it is enriched with oxygen and then pumped back into the body. During this process, the blood is cooled down and warmed up again after the operation. as standard. This supplies the body with oxygen-rich blood and thus enables surgery under optimal conditions on the non-beating heart. In special cases, especially in the case of a calcified aortaThe main major artery in the body. Leads from the left ventricle via an arch in the thoracic cavity to the abdominal cavity. There it splits into two large iliac arteries., the operation can also be performed without a heart-lung machine, i.e. on the beating heart (OPCAB¸ off pump coronary artery bypass). Your surgeon will discuss which procedure is suitable for you during the consultation.