CABG (Heart Bypass Surgery)
Coronary Artery Bypass Grafting (CABG) is a major surgery to improve blood flow to the heart. CABG is used for patients who have severe Coronary Heart Disease (CHD), also called Coronary Artery Disease.
In CHD, a substance called plaque (plak) builds up inside the arteries of the heart. These arteries supply oxygen-rich blood to your heart. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood.
In CABG, the blocked arteries are bypassed with a blood vessel graft to restore normal blood flow to the heart. The goal of CABG is to create a new passage & re-route the blood flow around the blocked arteries thereby improving the supply to the heart muscle.
The blood vessel graft is usually taken from the leg (saphenous), arm (radial) or chest (internal thoracic or internal mammary).
Why is CABG done?
Coronary arteries supply blood to the heart muscle. In some cases, plaque built up in them which causes narrowing or even blocking the blood from passing through the arteries. So the heart will not receive adequate blood supply which leads to heart attack.
When the coronary arteries are blocked the team recommends coronary artery bypass surgery or CABG. CABG is done to relieve symptoms caused by the accumulation of plaque in the coronary arteries like chest pain, irregular heartbeat and shortness of breath.
How do we get ready for the procedure?
The cardiac surgeon is the best person if you have any apprehensions before the surgery.
Discuss with him/her about:
- The disease
- Why surgery is required
- Right time for surgery
- Expectations, during & after surgery
- Any allergies
- Family history of diabetes
- Complete blood count (CBC): To prepare the doctor in case a blood transfusion is required.
- Prothrombin time (PT) and thromboplastin time (PTT) values: These tests show altered values in presence of any bleeding or clotting disorders or if you’re taking any blood-thinning medications.
- Chest X-ray: To check the size and shape of the heart and aorta.
- Cardiac catheterization: This test helps your doctor in planning the surgery as this test locates the blockages in your coronary arteries.
- Other tests, such as kidney and liver function tests
What happens during the Bypass Surgery?
The Cardiac surgeon makes a long cut in the center of your chest and opens the rib cage. Your heart is temporarily kept still during the procedure & with the help of a heart-lung machine the blood keeps circulating through your body.
Then the surgeon builds the bypass. First, a healthy artery is removed from your chest or wrist or a vein from your leg, this is known as graft and thereafter this graft is attached to that artery above and below the one the blocked artery.
Once the surgery is complete, blood will flow to your heart through your new graft.
Risks associated with a Bypass Surgery
- Blood clots which can increase the risk of stroke
- Excessive bleeding
- Abnormal heart rhythms (arrhythmias)
- Breathing problems
- Fever and pain
- Kidney failure (rare)
- Loss of memory (rare)
Recovery after your Bypass Surgery
- Recovery time after surgery ranges from four to six weeks and it also depends on the patient’s general health
- Keep an eye for any signs of redness, swelling or drainage from the wound
- The doctor may prescribe pain medications, anti-arrhythmics and anti-coagulants after the surgery
- Avoid stress
- Avoid alcohol and quit smoking for a speedy recovery
Is CABG open heart surgery?
- Yes, CABG is an open heart surgery.
What is the recovery time after CABG?
- The patient has to stay in hospital for 5-7 days after CABG. Normal recovery from heart surgery takes four to six weeks.