Coronary Artery Bypass Grafting Surgery

Overview

Coronary artery bypass grafting surgery (CABG) is a surgical procedure that helps improve the blood flow of the heart. This procedure is used to treat heart diseases such as heart attack, silent myocardial ischemia, and angina pectoris which is mostly due to atherosclerotic coronary artery disease.

Coronary artery bypass surgery is performed when the coronary arteries narrow, including the blood vessels that supply nutrients and oxygen to the muscles in the heart.

Alternate Name

It is also known as heart bypass surgery.

How is it Performed

A surgeon makes an incision on the chest (middle), and the rib cage of the patient is spread apart to expose the heart. There are chances that the surgeon might opt for minimally invasive surgery. This includes tiny cuts, special miniaturized equipment or a robotic process.

A heart-lung machine (cardiopulmonary bypass machine) keeps circulating oxygen or blood flow in the body during the surgery. Now a days advance and skillful surgeons can conduct the bypass surgery without the use of heart lung machine, generally known as off-pump CABG.

In general, the surgeon draws a healthy blood vessel from the chest and leg to bypass the arteries blocked. The graft's end is connected beyond the blockage to provide blood to the heart.

At our institution we perform total arterial revasculaisation using bilateral chest vessels known as internal mammary arteries which provide better symptom relief (due to superior graft patency rates) along with overall survival benefit.

Preparation

Before a surgeon performs a coronary artery bypass surgery, they will conduct preparations including the following checkups:

  • Tests
    A doctor will recommend a few tests before the surgery, including blood tests, an electrocardiogram (EKG), chest X-ray and an echocardiogram.
  • Diet, Physiotherapy and Medicines
    Before heart surgery, a doctor will recommend a diet chart to follow. In addition, they will add some medications before surgery. Physiotherapy for optimisation of pulmonary function may be advised
  • Supplements
    Sometimes, people take regular supplements which may increase risks during surgery. The doctor might eliminate the intake of some of these supplements.
  • Hospital Admission
    Depending upon the results of the tests conducted and the patient’s health condition, a patient might be admitted one day before surgery.

Procedure Type

Surgical

Follow Up

After the surgical procedure, the patient might feel pain at the incision site while breathing deeply or coughing. They will be monitored in the ICU for around two days. If the heart's blood and oxygen flow are good, they will then be shifted to the ward of the hospital.

Post-surgery, patients need to take care of their incision wounds and keep them away from water. The doctor will also suggest bed rest for a few weeks, for the patient to properly recover. Furthermore, patients are asked to avoid heavy-lifting for 4 weeks to 6 weeks after their surgery.

Risks

After coronary artery bypass surgery, there may be some possible risks, including:

  • Bleeding
    The patient may experience bleeding during or after surgery.
  • Infection
    If the wound is not cleaned or cared for properly, it may lead to an infection in the incision area.
  • Breathing Difficulties
    Patient should follow physiotherapy instructions to avoid difficulties related to breathing.

Recovery

There is no specified recovery time after heart bypass surgery. A doctor will prescribe medicines for reducing the pain .The antiplatelet drugs will help the patient recover well after surgery. However, if a patient is suffering from diabetes and liver or stomach problems, there might be some changes in prescription. A doctor might change medicines and suggest suitable medication plans for the patient.

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