Heart Bypass Surgery is also called Coronary Artery Bypass Grafting (CABG) is a procedure to treat individuals with blocked or narrowed coronary arteries. The aim of coronary artery bypass graft surgery is to restore blood flow to the heart muscle by creating a bypass around the narrow or blocked coronary artery. It is a commonly performed procedure and is considered a safe and effective way to treat individuals with coronary artery disease. This procedure improves quality of life, relieves symptoms such as chest pain, and reduces the risk of future heart problems.
Heart Bypass Surgery
Benefits of CABG surgery
Some of the benefits of CABG include:
Improved blood flow to the heart.
Reduced risk of heart attack and other heart-related complications.
Improved quality of life.
Can lead to a longer life expectancy compared to non-surgical treatments for CAD.
Why is CABG performed?
Some reasons why CABG is performed include:
Restoring blood flow: CABG is performed to restore proper blood flow to the heart muscle in individuals with severe coronary artery disease. It addresses blockages or narrowing in the coronary arteries, which hampers blood supply to the heart. By creating new pathways using grafts, the surgery bypasses the obstructed areas, allowing improved blood flow and oxygen delivery to the heart.
Alleviating angina: Angina, characterized by chest pain or discomfort, is a common symptom of coronary artery disease. CABG helps alleviate angina by improving blood flow to the heart muscle. By bypassing the blocked or narrowed arteries, the surgery reduces the strain on the heart and episodes of chest pain.
Reducing the risk of heart attacks: Severe coronary artery disease can increase the risk of heart attacks or myocardial infarctions. CABG can significantly reduce this risk by bypassing the diseased coronary arteries and creating new pathways for blood flow. By restoring blood supply to the heart, the surgery helps protect against heart muscle damage caused by heart attacks.
Improving heart function: When coronary arteries are severely blocked, the heart may struggle to pump blood effectively, leading to reduced heart function. CABG aims to improve heart function by restoring proper blood flow. By ensuring adequate oxygen and nutrient supply to the heart muscle, the surgery helps improve overall heart performance and may enhance the individual's quality of life.
Alternative when other treatments are inadequate: CABG is considered when other options, such as medication or angioplasty (a procedure to open narrowed arteries), are insufficient or unsuitable for the patient. It is often recommended for individuals with complex or extensive coronary artery disease, multiple blockages, or previous unsuccessful interventions. CABG provides a more comprehensive and durable solution to address severe coronary artery disease.
Who is a candidate for CABG?
Patients who may be considered for a CABG procedure include those:
With significant blockages in multiple coronary arteries.
With left main coronary artery disease.
Coronary artery disease with diabetes.
Who cannot be treated with medications or other less invasive procedures like angioplasty.
Other factors that may be considered include the severity of their symptoms, the patient's age and their overall health.
The doctor will take the patient's personal and family medical history.
The patient will have to undergo a battery of lab, diagnostic and imaging tests like blood tests, chest x-rays, electrocardiograms (ECGs), echocardiograms, stress tests and more to ensure they are fit for the procedure.
The doctor may start or stop certain medications before the procedure; they will also ask what the patient is using currently.
It is advised that individuals quit smoking a few weeks before since it can interfere with healing.
Exercising regularly before the procedure can help with post-operative healing.
How is the procedure performed?
The patient is given general anaesthesia, and their heart is usually stopped temporarily with a machine so the surgeon can perform the procedure. The patient is then placed on a heart-lung machine, which takes over the functions of the heart and lungs during the surgery.
The surgeon removes a healthy blood vessel, typically from the chest, leg, or arm, to use as a bypass graft.
The surgeon then makes a small incision in the chest to access the heart and the coronary arteries. They will sew one end of the graft to the aorta (the main artery leading from the heart) and the other end to the coronary artery beyond the blocked or narrowed area.
The graft is sewn securely in place, ensuring blood flows smoothly through it. It creates a new path for blood to reach the heart muscle, bypassing the blocked or narrowed area.
After the graft has been secured, the surgeon will close the incision in the chest.
Risks and Complications
Risks of CABG include:
Poor wound healing
The patient has to stay a few days in the hospital, depending on the procedure performed.
It is important that patients do not lift heavy objects, perform strenuous activities or operate heavy machinery.
It can take 4-6 weeks or more to make a full recovery.
Regular follow-ups help doctors monitor any complications.
Patients are encouraged to take cardiac rehabilitation therapy to help strengthen their heart.
Pain relief medications are provided to keep patients comfortable while they heal.
Reviewed by Dr. Rajneesh Malhotra, Vice Chairman & Head, Cardiac Sciences, Cardiac Surgery (CTVS), Robotic Surgery.
How long does artery bypass surgery take? Artery bypass surgery can take anywhere between 3-6 hours, depending on the extent of the condition.
Is it better to use an artery or vein for bypass surgery? Yes, arterial grafts have better longevity of the grafts.
Can you live with blocked arteries? Yes, one can live with blocked arteries, but it can make one prone to heart attacks and risk to life. People should take care of this by eating a healthy diet, exercising regularly and visiting the doctor regularly.
What is the most common complication after open heart surgery? Complications after open heart surgery include poor wound healing, bleeding, pneumonia, and arrhythmia, to name a few.
What is the difference between bypass surgery and open heart surgery? Bypass surgery and open heart surgery are two different procedures. Whenever we open the heart to repair any hole or intracardiac defect or replace/repair the valves, we have to open the chambers of the heart; it is called open heart surgery. But typically, for coronary artery bypass grafting (CABG) or bypass surgery, we are not required to open the heart; we only have to open the chest, so in true words, it is not open heart surgery. But in common reference, many people call bypass surgery as open heart surgery, which is incorrect.
How many arteries can be bypassed? We have 3 coronary arteries; these coronary arteries and their branches are bypassed. The number of grafts depends on the number of arteries that are critically blocked.
Is CABG a major surgery? Yes, any cardiac surgery is major surgery.
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