The IMA supplies blood to the lower part of the colon. Most often the colon can live without blood from the IMA, as it can receive blood from other surrounding blood vessels. At this point we decide whether to implant the IMA or not. Often times we will now asked the anesthesia people to give a medicine to counteract the heparin, in order to promote clotting. When we are happy that the bleeding and oozing is controlled, we then start to close.
Closing involves several steps.
The aorta is close over the graft, to minimize graft exposure. The last step involves examining the feet to ensure there is adequate blood flow. The operation time can vary substantially, often from 2.5 to 5 hours. There are many potential problems that can arise which will add to the operative time. Additionally, some surgeons are slower than others.