A Simple Explanation
This surgery, also called bypass surgery, restores normal blood flow to an obstructed coronary artery.
What is CABG Surgery?
Coronary Artery Bypass surgery or CABG surgery is commonly called Heart bypass or Bypass surgery.
This surgery is performed on patients with coronary artery disease, the narrowing of the Coronary arteries due to the build of fatty deposits called Plaque. This surgery is usually done when other treatments like lifestyle changes, medications and angioplasty, a procedure to open up the arteries, are not effective.
In this surgery, the surgeon creates a ‘bypass’ or a new path for the blood to flow to the heart, bypassing the blocked part of the artery.
After the CABG surgery, the patient is suggested to undergo lifestyle changes and medications to prevent the arteries to get clogged again.
Who needs CABG Surgery?
The doctor usually decide a patient for CABG based on the below factors:
- Presence and severity of the Coronary Artery Disease
- Severity and location of blockages in the coronary arteries
- Response to other treatments
- Patient’s quality of life
- Other medical conditions of the patient
How is it Diagnosed?Patient will undergo a physical exam that includes the heart, lungs and pulse.The patient’s symptoms like chest pain, shortness of breath are analyzed.The patient has to undergo the following tests to give a better picture of the blockages and the health of the coronary arteries.
- Electrocardiogram (ECG) to record the heart’s electrical activity
- Echocardiography (echo) to create the heart’s moving picture to study heart’s present state.
- Stress Test to analyze the heart’s activity under stress.
- Coronary Angiography to see the insides of the coronary arteries.
Risks of CABG Surgery
The general risks are:
- Infection at the incision sites
- Reactions to Anaesthesia
- Pain at the incision sites
- Stroke, Heart attack
- Chronic stress
There are different types of CABG surgery. They can be broadly divided into Traditional and the newer, less-invasive non-traditional approach.
The surgery is done under General Anaesthesia and might take 3-6 hours to complete, depending on the number of coronary arteries bypasses.
- During the surgery, the patient’s heartbeat, blood pressure, oxygen levels and breathing are checked.
- The chest bone is cut and the rib cage opened to reach the heart.
- The heart is stopped using medications, for the doctor to operate on.
- A heart-lung bypass machine supplies oxygen-rich blood throughout the body.
- A healthy artery is taken from the patient’s leg or chest, as the bypass graft.
- Once the grafting is finished, bloodflow to the heart is restored. Usually, the heart starts beating on its own; otherwise, mild shocks are used to restart the heart.
- The heart-lung bypass machine is disconnected.
- The fluid from the patient’s chest is drained using inserted tubes.
- The chest-bone is stitched using wire.
Non-Traditional CBAG approaches
In these approaches, the heart-lung bypass machine isn’t used always.
- Off-Pump CBAG: like the traditional CBAG, chest-bone is opened to reach the heart but the heart isn’t stopped.
- Minimally Invasive Direct CBAG (MIDCAB): This surgery is done through a small incision made between the ribs, directly over the artery, to be bypassed.
- The patient will be kept under observation in the ICU for a couple of days.
- After that, the patient will be moved to a less intensive care and allowed to recover for a couple of days,