Coronary artery bypass graft surgery

Coronary artery disease (CAD):

The blood vessels that supply pure oxygenated blood and nutrients to the heart are called coronary arteries. Inappropriate lifestyle habits like excess intake of junk foods containing trans fats or excess alcohol intake and lack of exercise may cause coronary artery diseases. The fatty material gets deposited along the coronary artery wall, narrowing the artery, & resulting in reduced supply of oxygenated blood. The medical condition is treated with the procedure called Coronary artery bypass graft surgery (CABG). 

What is Coronary artery bypass graft surgery?

CABG surgery or Coronary artery bypass graft surgery involves the grafting a blood vessel from a different part of the body, either from the chest, leg or an arm, and placed around the area of the blocked coronary artery, thus creating a bypass. The purpose of the surgery is to resume the flow of oxygenated blood to the heart by creating a new pathway. CABG is performed to improve the blood supply to the heart.

Coronary artery bypass graft surgery


Who requires a CABG

Coronary artery bypass grafting is recommended for:
·         Coronary artery bypass grafting is performed to treat people with coronary heart disease. The blockage in the arteries leads to heart attacks.
·         The patient whose heart pump rate is weak due to blockage in the coronary artery will need to undergo a CABG.
·         If medicines or other changes like diet or other related habits have not worked then CABG is recommended.
·         An attempt with percutaneous coronary intervention (PCI) or coronary angioplasty to treat blockages wasn’t successful, then the patient will have to opt for CABG.
·         Severity of CHD symptoms, location of blockages, poor response to the other treatments and the overall health status of the patient may also point towards a need for a CABG.

CABG Procedure

CABG surgery is a type of open heart surgery  performed by Cardiothoracic surgeons.  A healthy blood vessel from different part of body like leg, forearm, chest or wrist is used to bypass the blocked blood vessel and create an alternate channel for smooth supply of oxygenated blood to the heart muscle.
Before the procedure, the medical team will monitor the vital signs of the patient like blood pressure, heart rhythm, and blood oxygen levels. The procedure is performed under general anesthesia. An incision is made in the middle of the chest and cut through the breastbone to spread apart the rib cage to gain access to the chest cavity. The sternotomy is followed by cutting through the pericardium to access the heart for bypass procedure.
The surgeon removes a portion of a healthy blood vessel or graft from leg, forearm or chest. He then attaches it just below the blockage in the affected coronary artery by sewing the graft. A new channel is thus established for a smooth supply of oxygenated blood to the heart. Similar procedure is repeated on other blocked vessels, if present to enable smooth blood flow.
The surgery lasts for 4 to 5 hours depending on the number of blockages to be treated. The heart-lung machine is disconnected at the end of the surgery and the heart starts beating on its own with the normal flow.     

Recovery Post Surgery

The patient is transferred to the ICU and monitored very closely for 4 - 5 days. The vital signs like the pulse, heart sound, blood pressure and oxygen are closely monitored and recorded. It may take 2-3 months for full recovery from the surgery. If the surgery is a minimally invasive one, then recovery will be quicker.  The doctor’s instructions and follow-up care have to be strictly followed. The patient can get back to routine activities like driving in 6-8 weeks.


 

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