Actually removing them would make the procedure much more complex!
An interesting question which I have not seen addressed in any medical text. It is one reason I would recommend people continue taking statins as they stabilise plaque. I believe even a low maintenance dose, such as 10mg Atorvastatin, would do this.
“...make the procedure much more complex!” More complex than cleaving my breastbone from top to bottom; springIng my ribs apart; slicing open the heart sac; grabbing hold of the heart and turning it around, while operating on it! Not to mention all the other little things going on like harvesting of veins! 😉
I think it's the microsurgery involved with stripping out the blocked arteries - it takes specialised skill, more so than the skill required to harvest veins (love the way you put that ), and more time.
Surgeons like to 'get in-get out' as quickly as possible to avoid having the patient 'on the table' under anaesthesia for too long. My late husband was a paediatric neurosurgeon and I well remember dinner table conversation with other consultants - one of the things they hated most about lengthy ops was having to keep a patient 'under' for extended periods. Another reason they spoke of why they tried to move through a procedure quickly (but efficiently) was hating having the patient's surgical wound open - theatres are scrupulously clean but the longer a wound is open the more chance there is of 'something'.
My surgeon drew me some pictures when we were discussing the procedure. As you say it is very delicate work. Sewing up the bypass definitely is. If a section was cut out they would have to stitch on the "blind side" increasing risk of subsequent internal bleeding. My quadruple took eight hours which was long enough even though I slept like a baby! 😴
Oh ooh, eight hours, oooooh! People who've not undergone ohs don't always understand why patients hurt after - it's not the incision(s) so much as it's the hours of having the ribs spread. Oh my goodness I'm aching just thinking about it!
I came around a few hours later feeling like the victim of a Big Daddy Splash! The rib pain went after four weeks but issues with my right hand (ulnar nerve "nipped" in shoulder) continued for months! ☹️
It was an April Fool's on Panorama. My great nephew loves spag bol and watched in in wide eyed fascination a few years ago. He now knows it comes from supermarkets but understands that like milk it all starts on the farm.
Hope the Doctor title is a kind of compliment! Just to clarify I am not medically qualified but have a keen interest in cardiolgy because of family history and my own cardiac journey. It definitely is a very interesting question.
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