Coronary Artery Bypass Grafting
Other Names for Coronary Artery Bypass Grafting
Bypass surgery
Coronary artery bypass surgery
Heart bypass surgery
CABG is one 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 (that is, goes around) the blocked portion of the coronary artery.
This creates a new passage, and oxygen-rich blood is routed around the blockage to the heart muscle.
If you're a candidate for CABG, the goals of having the surgery include:
Improving your quality of life and decreasing angina and other CHD symptoms
Allowing you to resume a more active lifestyle
Improving the pumping action of your heart if it has been damaged by a heart attack
Lowering the risk of a heart attack (in some patients, such as those who have diabetes)
Improving your chance of survival
Types of Coronary Artery Bypass Grafting
Traditional Coronary Artery Bypass Grafting
This is the most common type of coronary artery bypass grafting (CABG). It's used when at least one major artery needs to be bypassed.
During the surgery, the chest bone is opened to access the heart. Medicines are given to stop the heart, and a heart-lung bypass machine is used to keep blood and oxygen moving throughout the body during surgery. This allows the surgeon to operate on a still heart.
After surgery, blood flow to the heart is restored. Usually, the heart starts beating again on its own. In some cases, mild electric shocks are used to restart the heart.
Off-Pump Coronary Artery Bypass Grafting
This type of CABG is similar to traditional CABG because the chest bone is opened to access the heart. However, the heart isn't stopped, and a heart-lung bypass machine isn't used. Off-pump CABG is sometimes called beating heart bypass grafting.
Minimally Invasive Direct Coronary Artery Bypass Grafting
This surgery is similar to off-pump CABG. However, instead of a large incision (cut) to open the chest bone, several small incisions are made on the left side of the chest between the ribs.
This type of surgery mainly is used for bypassing the blood vessels in front of the heart. It's a fairly new procedure that's done less often than the other types of CABG.
This type of CABG isn't for everybody, especially if more than one or two coronary arteries need to be bypassed.
What To Expect After Coronary Artery Bypass Grafting
Recovery in the Hospital
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.
An intravenous line (IV) will likely be inserted into a vein in your arm. Through the IV line, you may get medicines to control blood circulation and blood pressure. You also will likely have a tube in your bladder to drain urine and a tube to drain fluid from your chest.
You may receive oxygen therapy (oxygen given through nasal prongs or a mask) and a temporary pacemaker while in the ICU. A pacemaker is a small device that's placed in the chest oWhile 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. While in the ICU, you'll also have bandages on chest incision (cut) and on the legs or hand.
Recovery at Home
Your doctor will give you specific instructions for recovering at home, especially concerning:
How to care for your healing incisions
How to recognize signs of infection or other complications
When to call the doctor right away
When to make follow-up appointments
You also may get instructions on how to deal with common side effects from surgery. Side effects often go away within 4 to 6 weeks after surgery, but may include :
Discomfort or itching from healing incisions
Swelling of the area where an artery or vein was removed for grafting
Muscle pain or tightness in the shoulders and upper back
Fatigue (tiredness), mood swings, or depression
Problems sleeping or loss of appetite
Constipation
Chest pain around the site of the chest bone incision (more frequent with traditional CABG)
Full recovery from traditional CABG may take 6 to 12 weeks or more. Less recovery time is needed for nontraditional CABG.
Ongoing Care
Care after surgery may include periodic checkups with doctors. During these visits, tests may be done to see how your heart is working. Tests may include EKG(electrocardiogram), stress testing, echocardiography, and cardiac CT.
CABG is not a cure for coronary heart disease (CHD). You and your doctor may develop a treatment plan that includes lifestyle changes to help you stay healthy and reduce the chance of CHD getting worse.
Lifestyle changes may include making changes to your diet, quitting smoking, doing physical activity regularly, and lowering and managing stress.
Your doctor also may refer you to cardiac rehabilitation (rehab). Cardiac rehab is a medically supervised program that helps improve the health and well-being of people who have heart problems.
Rehab programs include exercise training, education on heart healthy living, and counseling to reduce stress and help you return to an active life. Doctors supervise these programs, which may be offered in hospitals and other community facilities. Talk to your doctor about whether cardiac rehab might benefit you.
Taking medicines as prescribed also is an important part of care after surgery. Your doctor may prescribe medicines to manage pain during recovery; lower cholesterol and blood pressure; reduce the risk of blood clots forming; manage diabetes; or treat depression.
Conduits Used for Bypass grafting
Bypass Grafts
Sometimes we have to remove calcified thickened tube like material from within the Artery Called PLAQUES. This procedure is called ENDARTERECTOMY
Endarterectomy Specimen
