Coronary artery bypass grafting (CABG)
Coronary artery bypass grafting (CABG) is a form of surgery utilized to treat and take care of people who have serious coronary Heart Disease (CHD).The procedure really helps to enhance the flow of blood towards the heart.
In an individual afflicted by CHD (a Heart / Cardiac Disease), a substance that is waxy plaque (plaque) builds within the coronary arteries. These arteries supply oxygen-rich bloodstream to your heart. This plaque can harden or rupture (break open) with the passing of time. Hardened plaque narrows the arteries which can be coronary reduces the flow of oxygen-rich bloodstream to the heart. This will cause chest discomfort or pain called angina. And if the plaque ruptures, a blood clot can form on its surface. A large blood clot can mostly or completely block blood movement through a artery that is coronary. This is actually the most cause that is common of heart attack. As time passes, ruptured plaque additionally hardens and narrows the arteries that are coronary.
Off-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery – heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery
Why it is Performed
Symptoms of coronary artery disease may include, but are not limited to, the following:
- • Chest pain
- • Fatigue
- • Palpitations
- • Abnormal heart rhythms
- • Shortness of breath
When heart has severe blockages in large coronary arteries, especially if heart's pumping action has already weaken the artery. Coronary grafting (CABG) is a type of heart surgery that improves blood circulation to the heart. Surgeons perform CABG to deal with individuals who have severe coronary heart disease(CHD).
CHD is a disease in which a substance that is waxy plaque (plak) builds up within the coronary arteries. These arteries supply oxygen-rich bloodstream to your heart. With time, plaque can harden or even rupture (break open). Hardened plaque narrows the arteries being coronary reduces the flow of oxygen-rich blood to heart. This could cause chest discomfort or pain called angina.
A bloodstream clot could form on its surface in the event that plaque ruptures. a large blood clot can mostly or completely block blood flow through a coronary artery. This is the most common cause of heart attack. Over time, ruptured plaque also hardens and narrows the coronary arteries.
CABG is one treatment for CHD. During CABG, a healthy artery or vein through the body is connected, or grafted, to the blocked coronary artery. The grafted artery or vein bypasses (that is, goes around) the blocked portion of the coronary artery. This creates a path that is new oxygen-rich blood to flow to one's heart muscle mass.
Test & Diagnosis
Cardiologists diagnose the need for Coronary artery bypass grafting (CABG) surgery based on medical and family histories, a physical exam, and the results from some heart-monitoring tests like.
- • Electrocardiogram (ECG),
- • Holter monitor,
- • TMT (stress test)
- • Echocardiogram,
- • Angiography
- • Cardiac Computerized Tomography (CT) Or
- • Magnetic Resonance Imaging (MRI).
If the coronary heart disease (CHD) is not found during the above tests doctors/surgeon suggests for some advanced tests or prescribe for medical management.
How CABG is performed
CABG surgery usually lasts three to six hours. However, it may take longer according to exactly how many blood vessels have to be grafted. Blood vessels is taken from your leg (saphenous vein), within your chest (internal mammary artery) or your arm (radial artery). Other blood vessels in these particular areas are able to pay for the loss in these blood vessels after the operation.
The quantity of vessels used depends on how severe your cardiovascular disease is and exactly how many coronary blood arteries are damaged. Many people will need three or four vessels grafted. You may hear your operation named a 'double', 'triple' or 'quadruple' bypass depending on the number of grafts used.
One of the graft vessels is generally a internal mammary artery from the chest. Surgeons prefer to use this vessel since it does not narrow in the long run, unlike the blood vessels taken from arms or legs.
Once all the graft vessels have been removed, doctor shall make a cut (incision) down the midst of upper body so they really can divide breastbone (sternum) and access heart.
During the procedure, blood may be re-routed to a heart lung bypass machine. This Machine takes over responsibility of your heart and lungs, i.e. pumping blood and oxygen to your body. Heart will be temporarily stopped using medication while doctor attaches the new grafts to divert the blood supply across the obstructed heart artery.
Following the grafts have been attached, heart will soon be started again using controlled electric shocks. Sternum will then be fixed together using metal that is permanent plus the skin in your upper body sewn up using dissolvable stitches.
CABG Surgery Risks
- Nonunion of the sternum; internal thoracic artery harvesting devascularizes the sternum increasing risk.
- Myocardial infarction due to embolism, hypoperfusion, or graft failure.
- Late graft stenosis, particularly of saphenous vein grafts due to atherosclerosis causing recurrent angina or myocardial infarction.
- Acute renal failure due to embolism or hypoperfusion.
- Stroke, secondary to embolism or hypoperfusion.
- Vasoplegic syndrome, secondary to cardiopulmonary bypass and hypothermia
- Grafts last 8–15 years, and then need to be replaced.
- Pneumothorax: An air collection around the lung that compresses the lung.
- Hemothorax: Blood in the space around the lungs.
Life after CABG Surgery
A coronary artery bypass graft (CABG)is not a cure for Coronary heart disease, so it's important to adopt a healthy lifestyle and continue taking any prescribed medication after the operation to reduce the risk of heart problems in the future patient should adopt to following
- • Healthy lifestyle
- • Healthy diet
- • Exercise regularly
- • Lose weight
- • Stop smoking
After surgery, there will be a short stay of about 1 to 2 days in the intensive Care Unit (ICU)(if there are not any complications). Within the ICU, patient will likely have constant monitoring of his or her heart/health that is complete activity.
Typical stay in a healthcare facility shall be of 3 to 8 days after open-chest bypass surgery. The duration of patient's hospital stay will be determined by the general health before bypass surgery and whether complications develop from surgery.
After release, recovery at home takes 4 to 6 weeks. Recovery includes physical respiratory therapy, occupational therapy, and diet counseling. Driving and exercise may be resumed after about two to three weeks. Individuals who are able to get back to work can do so within frequently 1 or 2 months, with respect to the form of work they do. Some people find that they experience heightened emotions for approximately a year after surgery.
Prognosis of CABG depends an range of factors, and successful grafts typically lasts 8–15 years. The huge difference in survival rate between those who've had surgery and those treated by drug therapy diminishes as a whole, CABG (generally triple or higher bypass) improves the chances of survival of patients at risk. Age at the time of CABG surgery is critical to the prognosis, younger patients with no complicating diseases do better, while older patients can usually be anticipated to suffer blockage that is further of coronary arteries.
Cost of the CABG Surgery varies person to person and depends on the overall health condition of the patient and also choice of the healthcare facility and Hospital Room, however average price of the Medical Procedure is around USD 6000- USD 9000 this is an all inclusive cost of surgery package.