Coronary Artery Disease

CORONARY ARTERY DISEASE

The heart is a muscle which requires an adequate blood supply for its optimal function.

Three major coronary arteries supply blood to the heart. Each of these arteries has multiple branches on the heart’s surface. 

• Left anterior descending (LAD) coronary artery
• Circumflex coronary artery
• Right coronary artery

When cholesterol and other cellular debris build up in the walls of the coronary arteries, this is termed atherosclerosis.  At the top of the diagram to the right, blood flows normally through an artery.  As atherosclerotic plaque builds up and ruptures, blood flow to the heart is diminished.  The heart muscle begins to starve.  If untreated, the heart muscle will eventually die causing a myocardial infarction, or heart attack.

Some risk factors for coronary artery disease can be changed by lifestyle alterations or medicines.  For more information on risk factors and coronary artery disease, click here. The cornerstone of the treatment of coronary artery disease is risk modification and medical therapy.  Other treatments include angioplasty and the placement of stents.  These procedures are performed by an interventional cardiologist in the cardiac catheterization lab.

CORONARY ARTERY BYPASS GRAFTING (CABG)

Many patients with severe narrowing of their coronary arteries will benefit from coronary artery bypass grafting. Bypass surgery is performed using the patients own arteries and veins to “bypass” the areas of blockage and deliver adequate blood to the heart muscle.  The most common arteries used are the internal thoracic (mammary) and radial arteries.  The internal mammary artery is next to the breastbone inside the chest.  The radial is one of two arteries that supply blood to the hand.  The most common vein used is the saphenous vein in the leg. 

Coronary artery bypass grafting usually involves an incision through the sternum, or breastbone.  

• The internal mammary artery is harvested through the sternal incision
• The radial artery is harvested through an incision in the forearm
• The saphenous vein is often removed using minimally-invasive endoscopic techniques

Coronary artery bypass surgery usually takes 3 - 4 hours and typically requires the heart/lung machine for a brief period during the operation. Patients usually spend 1 - 2 nights in the Surgical Intensive Care Unit (SICU). Most will sit in a chair 6 - 8 hours after surgery and are walking the following day. Patients usually leave the hospital 3 - 5 days after surgery.

After discharge, patients will be instructed to gradually increase their activity and exercise.  Patients usually return to driving and light work after a month and have unrestricted activity after 2 months.

If you or someone you know has coronary artery disease and would like to learn more about surgery, Dr. Pigott is available to discuss all your options.  If coronary artery bypass grafting has been recommended for you, Dr. Pigott is available to perform your surgery or simply give a second opinion.

To contact Dr. Pigott, call 1-800-988-5800 (press *) or email Dr. Pigott at JDP@NewOrleansHeart.com