What Is Quadruple Bypass Heart Surgery?

Understanding Quadruple Bypass Open Heart Surgery

Before and After Heart Bypass Surgery. ADAM

A quadruple bypass is a very serious surgery and complicated open heart procedure that is done to improve the blood flow that feeds the heart. Many people are diagnosed with heart disease--and the need for surgery--after experiencing chest pain, shortness of breath or common symptoms like arm or jaw pain. 

To really understand what is means to have a quadruple bypass, it is essential to understand the anatomy of the heart and effects of heart disease.


Coronary Artery Disease

The coronary arteries are the blood vessels that supply the heart with its own blood supply; these are different than the vessels that supply the blood pumped by the heart. To be clear, the heart pumps blood to the entire body through muscular contractions that keep blood moving.  The heart, like every tissue of the human body, also needs to be fed oxygen and nutrients from the bloodstream.  The blood vessels that feed the heart what it needs are called the coronary arteries and their small size can contribute to their becoming clogged easily with plaque. 

We care about the coronary arteries so much because, in some people, the coronary arteries become blocked--a condition known as coronary artery disease--where plaque builds up in the blood vessel.

If the blockage in the coronary artery is severe, it can prevent blood flow to the part of the heart that is fed by the diseased blood vessel, causing chest pain, also known as angina.

 If the blockage is severe enough, and the blood flow is dramatically decreased or completely stopped, a heart attack is typically the result. It is possible to have several arteries blocked in this manner, which can pose a significant risk to the heart.

Treatment For Coronary Artery Disease

In many cases, coronary artery disease can be treated with medication, lifestyle changes and less invasive procedures such as angioplasty.


Quadruple Bypass Surgery

For some patients, the blockage(s) are so severe that surgery is necessary to make sure the heart continues to receive adequate blood flow. This procedure is known as coronary artery bypass graft surgery (CABG), or heart bypass surgery. 

During the surgery, blood vessels are taken from another area of the body, often the leg, and grafted onto the existing heart vessel before and after the blockage. It is not unlike a quick detour your car might take to avoid an accident, with the blood literally being routed around the blocked portion of the vessel.

During the vast majority of quadruple bypass surgeries the heart is stopped so that the surgeon is not working on a moving target. This is done by using a heart lung bypass machine, a complex medical device that supplies oxygen to the blood instead of the lungs and pumps it through the body as the heart would normally do.  This machine allows both the heart and lungs to be still and makes it possible to complete the graft portion of the surgery more quickly.

The number of vessels that are severely blocked determines the number of grafts that will be performed during the procedure. If four vessels need to be bypassed, the surgery is referred to as a quadruple bypass because four grafts are performed.

If two vessels are bypassed, the surgery is called a double bypass and so on. Single bypasses are possible, but they are rare, as are quintuple bypass procedures where five vessels are bypassed.  


What Is Coronary Artery Bypass Grafting? National Heart Lung and Blood Institute. Accessed 2009. http://www.nhlbi.nih.gov/health/dci/Diseases/cabg/cabg_whatis.html

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