35682 Bypass graft; autogenous composite, 2 segments of veins from 2 locations (List separately in addition to code for primary procedure)

Name of the Procedure:

Bypass Graft; Autogenous Composite, 2 Segments of Veins from 2 Locations

Summary

This procedure involves using segments of the patient’s own veins taken from two different locations to create a bypass graft. It is typically performed in conjunction with another primary surgical procedure.

Purpose

Medical Condition

The bypass graft procedure is intended to restore blood flow around a blocked or narrowed artery.

Goals

• Improve blood circulation.
• Alleviate symptoms such as pain or swelling caused by poor blood flow.
• Prevent tissue damage due to inadequate blood supply.

Indications

Symptoms

• Severe pain due to artery blockage.
• Ulcers or non-healing wounds.
• Gangrene or tissue necrosis. ##### Patient Criteria
• Patients with significant artery blockages not suitable for less invasive procedures.
• Individuals with healthy veins suitable for grafting.

Preparation

• Fasting for at least 8 hours before the procedure.
• Discontinuation of certain medications (e.g., blood thinners) as instructed by the doctor.
• Preoperative assessments, including blood tests, ECG, and imaging studies.

Procedure Description

1. Anesthesia is administered, typically general anesthesia.
2. Veins are harvested from two different locations on the patient’s body.
3. Incisions are made at the blockage site and along the path of the intended bypass.
4. The harvested vein segments are surgically connected to create a new pathway around the blocked artery.
5. The graft is checked for proper blood flow.
6. Incisions are closed and bandaged.

Tools and Equipment

• Scalpel and surgical instruments.
• Clamps to control blood flow.
• Suture materials for joining vein segments.

Anesthesia

General anesthesia is commonly used, ensuring the patient is asleep and pain-free.

Duration

The procedure typically takes about 3 to 6 hours, depending on complexity and patient condition.

Setting

The procedure is performed in a hospital's operating room.

Personnel

• Surgeon specialized in vascular surgery.
• Surgical nurses.
• Anesthesiologist.
• Surgical assistants.

Risks and Complications

Common Risks

• Infection at incision sites.
• Bleeding or bruising. ##### Rare Risks
• Blood clots.
• Graft failure or blockage.
• Adverse reactions to anesthesia. ##### Management Management includes post-operative monitoring, antibiotics for infections, and medications to prevent blood clots.

Benefits

• Improved blood flow.
• Relief from pain and other symptoms.
• Prevention of tissue damage.
• Benefits are typically realized within a few weeks post-operation.

Recovery

• Hospital stay for a few days post-surgery.
• Wound care instructions and medication regimen to prevent infections.
• Gradual return to normal activities over 4 to 6 weeks.
• Follow-up appointments to monitor graft function and overall recovery.

Alternatives

Treatment Options

• Angioplasty with stenting.
• Medications to manage symptoms.
• Lifestyle changes. ##### Pros and Cons
• Less invasive options may be suitable for less severe blockages but might not provide the same long-term results as a bypass graft.

Patient Experience

During Procedure

• The patient will be under general anesthesia and won’t feel any pain. ##### After Procedure
• Post-operative pain managed with medications.
• Some discomfort and tightness in the chest and incision sites.
• Instructions on activity restrictions and wound care to promote healing and comfort.