Coronary arteries are blood vessels that carry oxygen and nutrients to the heart. Coronary Artery Bypass Surgery (CABS) is an operation that is carried out to improve the flow of blood to the heart muscle in people with coronary heart disease whose coronary arteries are severely narrowed or blocked. The operation involves taking blood vessels from other parts of the body and attaching them to the coronary arteries beyond the blockage. The blood is then able to flow around or bypass the blockage. If more than one artery is blocked you may need more than one bypass graft.
Traditional CABG: This is the most common type of CABG which is 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 machine is used to keep blood and oxygen moving throughout the body during surgery. This allows the surgeon to operate on a quiet heart. After the surgery, heart is restarted using mild electric shocks.
Off-Pump (Beating Heart) CABG: This type of CABG is similar to traditional CABG in that the chest bone is opened to access the heart. The only difference is that the heart isn't stopped and a heart-lung machine is not used. Off-pump CABG is sometimes called beating heart bypass grafting. This type of surgery may reduce complications that can occur when a heart-lung machine is used, and it may speed up recovery time after surgery.
Minimally Invasive CABG: This surgery is similar to beating heart, but instead of a large incision to open the chest bone, several small incisions are made on the left side of the chest between the ribs. This type of surgery is used mainly for bypassing the vessels in front of the heart. It's a new procedure, which has its own advantages like small incision, less blood loss, reduced pain, faster recovery. This type of surgery is not for everybody, especially if more than one or two coronary arteries need to be bypassed.
Stop smoking if you are smoker. You should stop smoking because smoking is a risk factor for coronary heart disease. Your heart disease will not improve if you continue to smoke. It also increases your risk of complication from the surgery.
Talk to your doctor or other people who have had the surgery. Knowing what to expect may help reduce your anxiety before the operation.
Plan for your care and recovery after the operation. Allow for time to rest, and try to get help for your day to day activities.
Coronary Artery Bypass Surgery is performed by team of surgeons.
The operation takes three to six hours, depending on how many blood vessels need to be bypassed.
A cut is made in the centre of the chest at the breastbone to allow the surgery to see the heart.
Another cut may be made in your leg to remove a vein that will be put in your chest. (In addition, an artery in the chest, called the internal mammary artery, can be used.)
If a vein is used for bypass, one end of it is sewn to the aorta (the main artery from the heart to the body). The other end is sewn to the area beyond the blockage in the coronary artery.
In the case of the mammary artery, the lower end of this artery is cut and attached to the coronary artery beyond the blockage.
When the surgery is finished, your chest is closed with stitches.
If your are healthy and under the age of 60, your risk of serious complications is 1%.
There are always some risks when you have general anaesthesia. Discuss these risks with your doctor.
There is a risk of stroke during and after the operation.
New blockages can develop in the bypass vessels. This might require another heart catheterisation and surgery. So it is important to make changes to your lifestyle to decrease the risk of another blockage.
You will go to the Intensive Care Unit (ICU) where you will stay for 2-3 days or long as you need for observation. An electrocardiogram (ECG) monitor will record the rhythm of your heart continuously.
You will have respiratory therapy to prevent any lung problem, such as a collapsed lung, infection, or pneumonia. A nurse or therapist will assess you with breathing exercise every few hours. Ask for pain mediation if you need it.
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