Coronary Artery Bypass Graft Surgery (CABG)

Coronary artery bypass graft surgery (CABG) is a procedure used to treat coronary artery disease. Coronary artery disease (CAD) is the narrowing of the coronary arteries – the blood vessels that supply oxygen and nutrients to the heart muscle. CAD is caused by a build-up of fatty material within the walls of the arteries. This build-up narrows the inside of the arteries, limiting the supply of oxygen-rich blood to the heart muscle. One way to treat the blocked or narrowed arteries is to bypass the blocked portion of the coronary artery with a piece of a healthy blood vessel from elsewhere in your body. Blood vessels, or grafts, used for the bypass procedure may be pieces of a vein from your leg or an artery in your chest. An artery from your wrist may also be used. Your doctor attaches one end of the graft above the blockage and the other end below the blockage. Blood bypasses the blockage by going through the new graft to reach the heart muscle. This is called coronary artery bypass surgery.

What are the preparations made before the surgery?

Taking medicines or doing exercises can be an easy thing, but going through surgery is comparatively difficult. This is why the patient has to perform certain activities so they are 100% ready for the surgery. The doctor makes sure that the patient knows the concept of the surgery. The patient will be provided with a form where the content for performing the surgery is to be given to the medical officials. It is advised to the patients to read the form carefully. If there is any doubt regarding the form or the procedure, they should directly ask their doctors about it.

How is coronary artery bypass graft surgery performed?

How much time it will take can be asked by the patient. Before the surgery takes place, your overall physical check-up is done to make sure you are ready for the surgery physically. You would be asked to stop eating or drinking anything before a certain time. Any allergies or medical conditions should be informed to the doctor. The procedure to get ready might vary from person to person based on their body.

Coronary artery bypass graft surgery procedure

Before the pumping or non-pumping procedure starts, there are a couple of steps done by the doctors. The first thing is the removal of any ornaments that might be a hurdle during the procedure. Now, anesthesia is given to you following the breathing tube getting inserted in your throat which is connected to a ventilator so you can breathe during the surgery. As soon as the types of equipment are ready, a cut will be made on your wrist or legs to get the blood vessel for grafting. Then, the main cut near the chest is made, and separate the chest into two parts to get a direct look at the heart.  After opening the chest area, the area near the arteries will be stabilized using unique equipment. There will be no issues in pumping blood through your heart. The bypass machine for the heart and lung is continuously checked by a medical professional so the bypass procedure can be done anytime. Depending on the level of the blockage, grafting will be performed on the patient. When the grafts are done, the doctor will check if it is working properly or not. After making sure that everything is done properly, the chest will be closed.

What are the ending steps included in the surgery?

Once the chest is closed, the doctor will begin concluding the surgery by sewing the sternum. Then, tubes are inserted into the chest to take out any fluid or excessive blood from the heart. The skin near the sternum will be sewed together. In the case of taking out the stomach fluid, a tube is inserted through the mouth or nose. The last step is applying a bandage to cover any open area. The patient is taken to the recovery room where they are monitored for any after-effects of the surgery. Some patients are not capable enough to breathe which is solved by having a tube in the throat connected to a ventilator.  The time after the surgery is only taken into consideration for judging how a coronary artery bypass graft surgery is affecting the patient. During the stay in the hospital, the patients are given pain killers or liquid food to improve the recovery period. Once your body is ready to be rested in your home using minute attention, you will be discharged. But a weekly check-up is recommended by the doctor to make sure no signs of coronary heart disease or blood clotting. 

What can you expect after the surgery?

There are different stages of coronary heart disease which are cured by different treatments. For small effects, medicines and changes in the lifestyle might help. The coronary artery bypass graft surgery is applicable for patients who are facing serious blockage in the arteries. After the surgery, the blockage is removed and the oxygen can travel without any problem. You can expect to get back on the positive track in your life. This happens because the surgery decreases the symptoms of coronary heart disease. As soon as your heart becomes active, it is only a while that your body starts to become energetic. In some cases, people experience a heart attack if the disease affects the heart greatly. The surgery helps in recovering the cells of the heart due to the attack. Not only the previous heart attack affects, but the arrival of any future heart attacks can also be minimized.  To achieve the best results after the surgery, the doctor might prescribe medicines and check-up which should not be neglected. Just because the surgery is done does not mean that your heart is in the right place forever. Some people might have to go through another surgery if the heart acts up again. What are the risks of coronary artery bypass surgery? Possible risks of coronary artery bypass graft surgery (CABG) include: • Bleeding during or after the surgery • Blood clots that can cause heart attack, stroke, or lung problems • Infection at the incision site • Pneumonia • Breathing problems • Pancreatitis • Kidney failure • Abnormal heart rhythms • Failure of the graft

Symptoms

Each body part holds equal importance so that the entire body can work properly. It is necessary to look after your body or get an overall check-up. This will make you aware of the changes you should make in your lifestyle for a better and healthy life. The blockage of the artery is the highest effect of coronary heart disease. But if the patient is aware of the symptoms, they can get a check-up done to cure the disease before it proceeds. The symptoms are as follows:

• Pain in the chest or near the heart
• Feeling tired
• Irregular heartbeat
• Improvement in sweating
• Difficulty in breathing
• Swelled hand or feet
• Redness in the chest
• Unable to digest food
• Pain while eating solid food

If you are experiencing any such symptoms, it is important to get them checked. Many patients find it hard to judge the symptoms so they should contact a doctor who can confirm the disease for them. Handling these small symptoms in time can decrease the chances of having surgery.

Causes

Coronary artery disease is thought to begin with damage or injury to the inner layer of a coronary artery, sometimes as early as childhood. The damage may be caused by various factors, including:

• Smoking
• High blood pressure
• High cholesterol
• Diabetes or insulin resistance
• Sedentary lifestyle

FAQ

What is the cost of the coronary artery bypass graft or cabg surgery?

It is an expensive procedure. Though cost ranges around $20,000 to $40,000 per person, it can vary depending on the facilities, technologies and the other medications prescribed by the hospital. In India, the cost differs in different metropolitan cities.

What is the time duration of cabg surgery?

The duration of coronary artery bypass graft surgery is almost 3-6 hours. Recovery alone takes 3-4 hours after surgery. Overnight stay is a must. The patient can stay up to 2-3 weeks according to the advice of the doctor. Regular visits may be required.

What are the coronary artery bypass graft surgery complications?

The complications include the risk of stroke, infections in the lungs, heart attack, allergic reactions in body parts, imbalanced functions of the kidney, bleeding, changes in a heartbeat and nerve injuries.

What condition does it cure?

It cures the blocked pathway of the coronary artery by providing the proper circulation of the blood through the heart into the other body parts. It has effective results almost all the time.

Is coronary artery bypass graft surgery painful?

No, it is not at all painful. During surgery, the patient is under general anaesthesia to numb any pain that can occur. During recovery, slight pain and discomfort are normal.