Coronary artery bypass grafting (CABG) is a type of surgery that enhances blood flow to the heart. CHD is a disease in which a viscous substance called plaque builds up inside the coronary arteries. This can narrow the coronary arteries and reduces the flow of oxygen-rich blood to the heart. This can cause chest pain or discomfort called angina
Deciding about the Treatment
To decide whether you’re a candidate for CABG, your doctor will do a physical exam. He or she will check your cardiovascular system, focusing on your heart, lungs, and pulse.
The doctor will also ask you about any symptoms you have, such as chest pain or shortness of breath. He or she will want to know how often and for how long your symptoms occur and how severe they are.
Tests will be done to find out which arteries are clogged, how much they’re clogged, and whether there’s any heart damage. There are some tests like EKG (Electrocardiogram), Stress test, Echocardiography related to the diagnostic.
Duration of Stay
8 days in the hospital, 12 days outside
After surgery, you’ll typically spend 1 or 2 days in an intensive care unit (ICU). Your heart rate, blood pressure, and oxygen levels will be checked regularly during this time. While in the ICU, you’ll also have bandages on your chest incision (cut) and on the areas where an artery or vein was removed for grafting. After you leave the ICU, you’ll be moved to a less intensive care area of the hospital for 3 to 5 days before going home.
Full recovery from traditional CABG may take 6 to 12 weeks or more. Less recovery time is needed for non-traditional CABG.
Your doctor will tell you when you can start physical activity again. It varies from person to person, but there are some typical timeframes. Most people can resume sexual activity within about 4 weeks and drive after 3 to 8 weeks.
Returning to work after 6 weeks is common unless your job involves specific and demanding physical activity. Some people may need to find less physically demanding types of work or work a reduced schedule at first.
If the plaque accumulated within the blood vessel ruptures, a blood clot can form on its surface. A large blood clot can mostly or completely block blood flow through a coronary artery. This is often the most major cause of a heart attack. Over time, ruptured plaque also hardens and narrows the coronary arteries.
CABG is a highly effective treatment for CHD. During CABG, a healthy artery or vein from the body is connected, or grafted, to the blocked coronary artery. The grafted artery or vein bypasses the blocked portion of the coronary artery creating a new path for oxygen-rich blood to flow to the heart muscle.
To find out whether a patient requires CABG surgery, your doctor will give you a physical exam. He or she will check the patient's heart, lungs, and pulse. The doctor will also inquire about any symptoms, such as chest pain or shortness of breath. He or she will want to know how often and for how long the symptoms occur, as well as how severe they are.
The doctor will recommend tests to find out which arteries are clogged, how much they're clogged, and whether you have any heart damage.
There are several tests and diagnostics which are done before the procedure. They are:
This surgery usually lasts 3–6 hours, depending on the number of arteries being bypassed. Many steps take place during traditional CABG. The patient will be under general anesthesia for the surgery. During the surgery, the anesthesiologist will check the patient's heartbeat, blood pressure, oxygen levels, and breathing. A breathing tube connected to a ventilator will be used to help the patient breath.
The surgeon will make an incision (cut) down the center of the patient's chest. The patient receive medicines which will stop the heart. This allows the surgeon to operate on the heart while it's not beating.
A heart-lung bypass machine will keep oxygen-rich blood moving throughout your body during the surgery. The surgeon will take an alternate artery or vein from the patient's body—for example, from your chest or leg—to use as the bypass graft. For surgeries with several bypasses, both artery and vein grafts are commonly used. Artery grafts. These grafts are much less likely than vein grafts to become blocked over time. The left internal mammary artery most often is used for an artery graft. This artery is located inside the chest, close to the heart. Arteries from the arm or other places in the body also are used.
Vein grafts. Although veins are commonly used as grafts, they're more likely than artery grafts to become blocked over time. The saphenous vein—a long vein running along the inner side of the leg—typically is used. When the surgeon finishes the grafting, he or she will restore blood flow to your heart. Usually, the heart starts beating again on its own. Sometimes mild electric shocks are used to restart the heart.
The results of CABG usually are excellent. The surgery drastically improves or completely relieves angina symptoms in most patients. Although symptoms can recur, many people remain symptom-free for as long as 10 to 15 years. CABG will lower the risk of having a heart attack and help the patient live longer.
You may need repeat surgery if blockages form in the grafted arteries or veins or in arteries that weren't blocked before. Taking medicines and making lifestyle changes as your doctor recommends can lower the risk of a graft becoming blocked.
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What to expect after coronary artery bypass grafting?
After your coronary artery bypass grafting procedure, you will generally spend 1 to 2 days in an intensive care unit. Your heart rate and blood pressure will be closely monitored and you might be given intravenous medicines to regulate your blood circulation and blood pressure. When your condition has stabilized, you will be moved to a less intensive care area of the hospital for 3 to 5 days of monitoring.
What are the risks of coronary artery bypass grafting?
Even though complications from coronary artery bypass grafting are uncommon, risk is a part of every surgical procedure. Potential risks include wound infection and bleeding, adverse reactions to anesthesia, fever, pain, stroke, heart attack, or even death.
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