Anastomosis
The point of connection between two blood vessels. When the surgeon sews a donor vessel to
a target vessel, the point of connection created by the surgeon is called an "anastomosis".
Anesthesiologist
A physician or other trained provider who puts you to sleep during any surgery. Various
medications or inhaled gases are used to induce a state of sleep, forgetfullness, and pain relief
during the operation.
Anesthesiologist
A physician or other trained provider who puts you to sleep during any surgery. Various
medications or inhaled gases are used to induce a state of sleep, forgetfullness, and pain relief
during the operation.
Angioplasty
This term refers to a procedure performed by a cardiologist through a small catheter in the
groin artery. A balloon is inserted through a narrowing in a blocked artery. Inflating the
balloon widens the area of the blockage and often relieves the blood flow deficit caused by the
blockage.
Artery
Red blood (rich with oxygen and nutrients) flows from the heart towards the body. The vessels
that carry blood towards the body tissue are called "arteries". Veins carry blue blood back
towards the heart.
Artery (Arterial) Grafts
Bypass grafts constructed from a donor artery taken from somewhere else in the patients body.
Artery grafts are smaller and more fragile but are more resistant to cholesterol plaque build up
and last longer than veins taken from the legs.
Atherosclerosis
Literally "hardening of the arteries". This is a process that advances with age and causes the
arteries to harden and become stiff. The mechanism is a build-up of fatty material,
particularly cholesterol, in the middle of the blood vessel wall. As the body reacts to these
fatty materials, inflammation and eventually calcium is deposited and a bulky plaque of material
builds up. Eventually enlargement of this plaque material can choke off the blood flow
channel.
Atherosclerosis
Literally "hardening of the arteries". This is a process that advances with age and causes the
arteries to harden and become stiff. The mechanism is a build-up of fatty material,
particularly cholesterol, in the middle of the blood vessel wall. As the body reacts to these
fatty materials, inflammation and eventually calcium is deposited and a bulky plaque of material
builds up. Eventually enlargement of this plaque material can choke off the blood flow
channel.
Cardiac Catheterization
An invasive study performed by a cardiologist which reveals the problems in your heart. The
patient must lay still on a table in the catheterization laboratory. A needle is inserted in the
groin and a plastic catheter is inserted and threaded backwards into the heart. Pressure
measurements are taken from the heart chambers. An angiogram (x-ray movies of the
arteries to the heart) is performed. A moving picture of the left-sided pumping chamber is
taken. All of these procedures together are referred to as a "cardiac catheterization".
Cardiac Catheterization
An invasive study performed by a cardiologist which reveals the problems in your heart. The
patient must lay still on a table in the catheterization laboratory. A needle is inserted in the
groin and a plastic catheter is inserted and threaded backwards into the heart. Pressure
measurements are taken from the heart chambers. An angiogram (x-ray movies of the
arteries to the heart) is performed. A moving picture of the left-sided pumping chamber is
taken. All of these procedures together are referred to as a "cardiac catheterization".
Congenital Heart Defect
A defect in the heart that the patient is born with. Common types include holes between the
heart chambers (septal defects) and abnormalities of the pumping chambers and great arteries
that arise from the heart. Most of these defects can be repaired with surgery or other less
invasive procedures.
Coronary Artery Disease (CAD)
The heart is a muscle which pumps oxygen-rich blood to the entire body. The pumping action
takes energy which the heart muscle cells derive from its own special blood supply. These small
feeder vessels run on the surface of the heart and deliver oxygen-rich blood directly to the heart
muscle cells themselves. Cholesterol plaque buildup in the inside of these small feeder vessels
can impair the blood supply of the heart, leading to complications like heart attacks, anginal
pains, and impaired pumping action of the heart (with symptoms of congestive heart failure).
Coronary Artery Bypass Grafting (CABG)
Since about 1970, it has been possible to restore the circulation to the heart with bypass
surgery. A vein or artery from somewhere else in the patient is transferred to the heart,
forming a "bypass" or "detour" around the narrowing in the native coronary artery. Since there
are usually multiple vessels blocked in the same patient, CABG (also known as "cabbage" surgery)
frequently implants multiple bypasses in order to completely restore the blood supply to the
heart.
Extubation
Removal of the breathing tube placed in the patients throat during surgery.
Gastroepiploic Artery
There are 4 blood vessels which supply red (oxygen rich) blood to the stomach organ (the second
part of the digestive tract laying just below the diaphragm). Two (2) of these blood vessels
run along the lower edge of the stomach organ and are called the right and left gastroepiploic
arteries (GEA). The right gastroepiploic artery (RGEA) is useful as a potential artery bypass
graft to the heart by bringing it over the liver into the chest.
Heart-Lung Machine
A device which pumps the blood around to the body and puts oxygen in the blood during a
patients open heart surgery. This machine permits the surgeon to temporarily stop the heart
while the needs of the body are served by the machine.
Hybrid Procedure
A combination of an open heart bypass operation (by a surgeon) and insertion of a stent (by a
cardiologist). During bypass surgery, some blood vessels cannot be bypassed and are better
treated with a stent inserted in the catheterization laboratory. The combination of surgery and
a stent procedure is called a "hybrid".
Internal Mammary Artery (IMA)
There are 2 arteries which travel just on the inside of the ribs along side of the breast bone.
These arteries supply some of the blood to the breast bone. They are also very resistant to
cholesterol build-up and make excellent bypass grafts. There is a right (RIMA) and left (LIMA)
internal mammary artery.
Intubation
Placement of a breathing tube into the main airway (trachea) of the patient. When the
patient is deep asleep, or cannot breathe for themselves, the breathing tube can be used to
bring oxygen and air into the patients lungs.
LIMA (Left Internal Mammary Artery)
The Left Internal Mammary Artery (see above).
Metastatic (Metastases)
Tumor cells which escape the original tumor site and grow in a different body organ or location,
forming a new mass or masses of tumor at a distant site from the original tumor.
MIDCAB
Minimally Invasive Direct Coronary Artery Bypass. A procedure developed in 1995 where a small
incision is made between the ribs ("thoracotomy") and a bypass performed between the nearby
Internal Mammary Artery (IMA) and the arteries on the surface of the heart. This procedure
is usually a single bypass.
Off-Pump (OPCAB)
This term refers to a technique for performing a bypass graft without stopping the heart and
without using the heart-lung machine. Motion of the target blood vessel is temporarily
suppressed by placing a stabilizing device on the surface of the heart. With motion
decreased, the surgeon can open the blocked heart artery and perform the bypass with sutures
and then remove the stabilizing device.
Patent (or Patency)
This term describes the number (or percentage) of bypass grafts that remain open after surgery.
Patency also applies to stents or balloon procedures. For example, if the patency rate is
90%, the 9 out of 10 of the blood vessels remain open (patent) after the procedure.
Plaque
An obstructing mass of cholesterol and inflammatory tissue in the wall of an artery, often
hardened by calcium deposits.
Radial Artery
One of the two arteries in the arm which feeds blood to the hand. The radial artery can be
used as a possible bypass graft to the heart. Harvesting the radial artery requires an incision in
the forearm.
RIMA (Right Internal Mammary Artery)
Right Internal Mammary Artery, one of the 2 blood vessels that travel on the side of the breast
bone and can be used for bypass graft material to the heart.
Saphenous Vein
This is a long, straight vein traveling from the ankle to the groin. There is one in each leg.
The saphenous vein is larger than the Internal Mammary Artery, but is not as long lasting.
Saphenous veins are the most versatile and most commonly used material for bypass grafting.
Sequential ("skip") graft
Hooking more than one heart artery onto the same bypass graft. In some cases, two or more
target arteries can be bypassed with the same piece of donor vessel, creating a series of hook-
ups.
Stenosis
A medical term which refers to the degree of narrowing in a blood vessel. Stenosis means
narrowing and the more severe stenosis, the more severe the narrowing. Stenosis is usually
rated as a percentage of the normal vessel diameter. For example, a stenosis of 70% means
the normal diameter is reduced by 70%.
Stent
A small cage of metal that can be inserted into a blood vessel and expanded. This cage holds
the vessel into a regular shape and prevents the blockages from coming back.
Sternum
The medical name for your "breast bone", the plate of bone in the front of your chest to which
all the ribs attach.
Sternotomy
Surgical division of the breast bone to gain access to the heart and other structures inside of the
chest. The bone can be split vertically with a saw (using either a vibrating or oscillating
blade). The bone fragments are brought back together and held in place with stainless steel
wires.
Sternotomy
Surgical division of the breast bone to gain access to the heart and other structures inside of the
chest. The bone can be split vertically with a saw (using either a vibrating or oscillating
blade). The bone fragments are brought back together and held in place with stainless steel
wires.
Thoracotomy
An incision between the ribs. Thoracotomy incisions are traditionally more painful than
incisions through the sternum (sternotomy). As the ribs are spread, the nerve travelling with
the rib is irritated causing pain.
Vein
Blood vessels that course through the body returning blue blood to the heart.
Xiphoid
A small tag of cartilage at the end of the sternum. The xiphoid process is not calcified (like
bone) and is not an important part of the structure of the chest. Removal of the xiphoid does
not cause any problems with the structure or function of the rib cage or breast bone.
