Coronary Artery Bypass Graft (CABG) is a surgical procedure performed on patients with Coronary Artery Disease. The procedure aims to improve the quality of life of patients in later years and improve mortality rates related to heart diseases. In this procedure, the clogged artery is bypassed with a healthy artery grafted from elsewhere in the body to improve blood flow to the heart.
The chances of developing a Coronary Artery Disease increase with age. The incidence also increases with other factors like obesity, smoking, or consuming a diet high in fats. This leads to deposition of plaques that narrows the arteries. Coronary artery disease can lead to chest pain or angina, which may require CABG. The number of bypass grafts depends on the number of arteries affected.
How is CABG surgery performed?
Before the procedure, the patient undergoes a pre-assessment check up with tests like ECG, Chest X-ray, blood work along with past medical and drug history.
The procedure is carried out under general anesthesia and lasts about 4 to 6 hours. It is advised to not eat or drink anything at least 6 hours before the procedure.
Blood vessels from the leg, chest, or arm are usually used as a graft. Surgeons usually prefer the blood vessels in the chest as these arteries do not narrow easily with time as the other blood vessels. Depending on the number of grafts needed, you may undergo a “double,” “triple,” or “quadruple” bypass surgery.
The blood is rerouted through a bypass machine, while the procedure is being done. The heart is temporarily stopped using medications until the new grafts are placed.
After all the grafts have been placed, the heart is put back into function using controlled electric waves. The breastbone will be reattached to the chest with permanent metal wires and the skin is sewn with dissolvable stitches.
Many surgeons today are opting for an Off-pump bypass surgery wherein the heart is still beating while the procedure is being done without the need of the bypass machine.
CABG requires a week of hospital stay with further recuperation at home. Care needs to be taken of the wounds, mainly stitches. Light activities can be resumed after 6 weeks and routine activities in about 8 to 10 weeks.
Complications of CABG
Minor side effects like loss of appetite, nausea, headache, constipation, difficulty in sleeping may be experienced, which are relieved within a few days. Major complications include:
- Infection of the wound
- Decreased kidney function. Temporary dialysis may be required in some patients.
- Heart attack
- In rare cases, death