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CORNONARY ARTERY BYPASS GRAFTING is a surgery for treating severe coronary artery heart disease (CHD) and therefore, improving blood circulation to the heart.

Why is it performed?

First we need to understand what coronary artery heart disease is. The arteries carry oxygenated blood to the heart. When plaque builds up inside the arteries, blood flow to the heart is obstructed. Lack of oxygen can cause pain in chest and if the plaques completely block the passage of oxygen rich blood, then a person succumbs to heart attack.

A newly grafted artery bypasses the blocked artery in order to normalize blood circulation, retain heart function and reduce chances of heart attack. This is the reason why CABG is performed.

Different Techniques of CABG

Traditional Coronary Artery Bypass Grafting

  • General anaesthesia is given to the patient. Then an incision is made by diving the breastbone to access the heart.
  • A heart-lung machine or extracorporeal circulation is then connected to the heart to maintain circulation of oxygenated blood throughout the body.
  • Medicines for stopping the heart beat are administered so that your doctor can operate your heart and simultaneously medicines for protecting the heart muscle are also administered
  • The bypass graft artery (left internal mammary artery) is collected from your chest or leg. After the bypass grafting is over, blood flow to the heart is restored and the heart-lung machine is removed. The incision is then sealed with stitches.
  • The surgery typically continues for 3-6 hours.

Off-Pump Coronary Artery Bypass Grafting

  • As the name suggests the heart continues beating and a heart-lung machine is not used during the surgery. Therefore, it is also known as beating heart bypass procedure.
  • The incision in the breastbone could be partial or full and special devices are used to stabilize the function of the heart.

Minimally Invasive Direct Coronary Artery Bypass Grafting

  • The other two techniques require about 10"-12" incision but MIDCABG can be done with minimal invasion, that too without performing a sternotomy to access the heart. A heart lung machine is also not used.
  • The technique is mainly performed in the frontal portion of the heart by making tiny incisions between the ribs for the purpose of placing the bypassed artery.
  • Robotic-assisted technique is one option for MIDCABG

How to prepare for the surgery?

  • Few common things that you must do before the surgery or the pre diagnostic tests are – stop smoking and drinking.
  • Your doctor will let you know what to eat and drink and what to avoid. He will also decide how long you need to keep your stomach empty before the surgery.
  • He will tell you which medicines are safe and which should be stopped.
  • You may have to undergo various tests like chest x ray, blood tests, coronary angiography, urine tests, EKG, echocardiography, etc before proceeding towards the surgery.

What to Expect?

  • After evaluating the condition of your heart and general health, your doctor will determine which type of CABG is suitable for you. You will be given anaesthesia while being operated.
  • After the operation, a breathing tube is inserted through the mouth, which is further attached to a ventilator. You will be kept in ICU for 1-2 days and during that period your heart rate, blood pressure and other functions of your body will be closely monitored. A temporary pacemaker will be placed inside your body.
  • You will definitely experience great deal of fatigue, drowsiness and may not be able to speak immediately after regaining senses.
  • Patients are discharged after a week, depending upon the response.
  • Your doctor will give you an array of advices regarding post operative care and you cannot afford to take any risk. Complete recovery takes 6-12 weeks.

Risks associated with CABG

  • Fever
  • bleeding
  • Wound infection
  • Heart rhythm irregularities

To end on a positive note, we encourage you to be mentally strong to undergo this massive operation. Make sure your loved ones are beside you to provide endless support and care. Listen to your doctor and take care of yourself.

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Written by: Saptakee sengupta

Date last updated: January 11, 2015