This allows access to the heart and the great vessels. For coronary surgery, other wounds are created for the harvest of bypass conduits. These wound may be in the legs, arms or the surface of the abdomen, to harvest the saphenous vein, the cephalic vein, the radial artery, or the inferior epigastric artery. A full laporaotomy is required for the gastroepiploic artery. Only the internal mammary artery does not require a separate wound.
All wounds have the potential to develop postoperative pain and infection.
In coronary surgery, leg wounds are the most common source of patient problems and complaints. In conjunction, cardioplegia is used to stop the heart. This provides the cardiac surgeon with an uncompromising bloodless quiet field, and a non-beating heart. Yet, the use of cardiopulmonary bypass is by far a major cause of morbidity, including strokes, embolic complications, pulmonary insufficiency, renal insufficiency, and coagulopathy causing significant postoperative bleeding. One must keep this in mind when evaluating any new minimally invasive approach.