And traditionally you just take veins from the leg, which is the saphenous vein. So what you're saying is the surgeon chooses the riskiest artery, makes that an arterial graft, and then everything else uses a vein.Īlistair Royse: Pretty much. Norman Swan: So this was a surprise when you told me that originally before we got you on, because I assumed that when you had coronary artery bypass surgery these days, and let's say you had three or four blocked arteries, that the blocked arteries got around, in other words grafted, that it was all arterial grafts. Norman Swan: Can you just summarise what the controversy is?Īlistair Royse: Internationally, coronary artery bypass surgery is done with a single arterial graft from the chest wall, the internal mammary artery, and then is supplemented by any number of vein grafts, and at about 3.2 grafts per patient average, then the majority of grafts from coronary artery bypass surgery being performed even today are from veins. Alistair Royse is Professor of Surgery at the University of Melbourne. A leading cardiac surgeon, however, is calling for significant changes to the way bypass surgery is done, arguing that only arteries should be used to graft on to the blocked vessel.
If it's deemed necessary to reopen blocked arteries, surgery is often recommended when high risk and multiple arteries are involved, it's called coronary artery bypass grafting, where the blockage is bypassed using a grafted artery or vein. The first sign of a problem can also be a heart attack or angina, chest pain when you exert yourself.
Norman Swan: Sudden cardiac death is the most dramatic and tragic manifestation of a blocked coronary artery.
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