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Can you help me understand where my bypass grafts are? 

Hi, I am trying to get a mental picture of where my bypass grafts are. I had blockage in the left main in 2005. In 2006, they stented this because it was said the LIMA failed to mature. The stent is 100% blocked. The LIMA is open but very small. I know the LIMA is attached from the aorta to the LAD. The surgery report says saphenous graft to the obtuse marginal. Is the saphenous graft also attached to the aorta? Does the obtuse marginal run off the circumflex? I know that I have diffuse disease of the LAD with 30% lesions and maybe small and some in the RCA. Also 40% in the ostium of the circumflex. Is the ostium where the beginning of where the circumflex runs off the LAD? I know blockages are only medically managed until the blockage is 75%. Is it possible if the blockage in the circumflex blocks off completely it will block blood flow to the SVG? Thank you.

submitted by Christine from Illinois 1/26/2013


by Texas Heart Institute cardiovascular surgeon, Denton A. Cooley, MD  

Denton A. Cooley, MDIn answer to your series of questions: Yes, the saphenous graft is sutured to the aorta at its proximal end. The distal end is sutured into the coronary artery beyond the obstruction, hence the name, bypass graft. The obtuse marginal artery is a branch off of the circumflex coronary artery. The circumflex artery and the left anterior descending artery are major branches which arise from the left main artery. Ostium means opening and denotes the foremost opening segment of a vessel. If a blockage in any native artery closes completely, blood flow ideally continues through whatever route is available, whether saphenous vein graft (SVG), mammary artery bypass, or collateral vessels. 

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Updated January 2013
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