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Coronary Artery Bypass Grafting

NICE Sky Med By NICE Ltd> Cardiology> Coronary Artery Bypass Grafting

Overview


Coronary Artery Bypass Grafting (CABG), commonly known as Bypass Surgery, is a surgical procedure that bypasses the blood flow around a blockage or narrowed section in the major arteries supplying blood and oxygen to the heart.

Anesthesia Type: General

About Aortic Aneurysm Repair

In CABG, a normal artery is taken from your leg, arm, chest or abdomen and connected it to the other arteries in your heart, bypassing the narrowed or blocked section.

CABG can be performed by 2 techniques

Off – Pump Or Beating Heart Surgery

On – Pump Or Cardiopulmonary Bypass Surgery

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Indication

Like all organs in your body, the heart also requires a constant supply of blood and oxygen. The left and right coronary arteries supplying these to the heart can develop a condition known as atherosclerosis, in which these arteries become narrowed due to fatty-acid buildup. The is a coronary heart disease. Severe atherosclerosis interferes with the supply of oxygen-rich blood to the heart muscles and cause chest pain, an ailment called angina.

Your cardiologist may CABG in the following situations:

Pre-Procedure

Your doctor will guide you through necessary medication, restrictions on diet and changes lifestyle ahead of your surgery.

Various pre-surgical tests like the electrocardiogram (ECG), coronary angiogram, chest X-rays and blood tests will determine your overall health and current status of artery blockages.

During-Procedure

The surgeon begins the procedure by removing a segment of a healthy artery or vein (graft) from another part of your body. Grafts are usually taken from the leg (saphenous vein), inside the chest (internal mammary artery) or the arm (radial artery).

Once the graft is ready, the surgeon makes an incision in the centre of the chest, along the breastbone, and spreads open the rib cage to access the heart.

Off – Pump or Beating Heart Surgery :- typically lasts 3 to 6 hours but may vary depending on the severity and number of blockages in the heart. The surgery is performed under the effect of a general anaesthesia. Using a stabilisation device, the area of the heart to be operated upon is immobilised and stabilized for the duration of the surgery.The surgeon stabilises the area of the heart to be worked on using a stabilisation device. The device gently attaches itself to the surface through small suction pods that will steady the’s movement in that area.

In On – Pump or Cardiopulmonary Bypass Surgery :- the heart is temporarily stopped and circulation of blood to body is done through the heart-lung machine.

Next, one end of the graft is attached to the area that lies just above the blockage in artery. The other end is attached to an area below the blockage. Once the graft is successfully implanted over the blocked blood vessel, normal blood flow resumes in that portion.

Post-Procedure

CABG is a major procedure. You will be monitored in the intensive care unit (ICU) for a day or two post the surgery before being transferred to regular hospital care for some more time, depending on your response to the procedure.

Lifestyle changes will be recommended by your surgeon after CABG. Medication will be given to lower your blood cholesterol, avoid blood clot and help your heart function as well as possible.

Risk and Complication

CABG can pose complications during and/or after the procedure, though your risk towards experiencing any complications depends greatly on the status of your health prior to the surgery, and is higher if the surgery is carried out as an emergency.

Possible risks from a coronary bypass surgery include:

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