Overview
CABG (Coronary Artery Bypass Graft) is a surgical procedure for treatment of coronary heart disease to allow blood to circulate in the clogged parts of arteries.
Coronary artery bypass grafting is done to improve the supply of blood to the heart. It is used for treating patients who have severe coronary heart disease (CHD).
A Coronary Artery Bypass Graft (CABG) operation is performed to re-route (bypass) blood around clogged arteries and improve the blood as well as oxygen supply to the heart. Over a period of time, these arteries often get clogged due to accumulation of fat and cholesterol and other substances.
The narrowing of the coronary arteries slows or stops the flow of blood from the heart’s vessels and can cause a heart attack.
How is Coronary Artery Bypass performed?
The procedure includes the following steps:
- During bypass surgery, a long length of an artery is detached from the chest wall (internal mammary artery) or one of the arms (radial artery) or a from a leg vein (saphenous vein).
- One end is sewn in the large artery that comes out from the aorta while the other end is attached or grafted to the coronary artery below the blocked area. Using the newly attached conduit, blood again flows freely to the heart muscle beyond the blockage.
- Small horizontal incisions are used to remove the vein from the leg instead of the long, painful, and difficult to heal incisions. Therefore, we do not see the usual wound problems with the leg incisions.
- A cardiopulmonary bypass with a pump and an Oxygenator (heart-lung machine) is used to increase patient safety. Though for some patients, operation can be performed on the beating heart (off pump surgery).
What are the risks associated with Coronary Artery Bypass Surgery (CABG)?
The possible risks can be:
- Infection at the incision
- Bleeding
- Breathing Problems
- Irregular heart beat
- Abnormal breathing patterns
- Graft Failure
- Blood clots, which can lead to stroke, lung infections
What are the long-term benefits of CABG?
The blood clots are formed in the grafts due to the small arteries that are beyond the insertion site of the graft. Therefore, it is possible that the vein grafts can get blocked after CABG surgery due to clotting of blood. The grafts become narrow because they stick to the inner lining and multiply, leading to the formation of a scar tissue. Recently, experts have started using internal mammary as well as other arteries instead of bypasses.
Doctors also advise to make lifestyle changes reduce the chance of developing atherosclerosis in the arteries. You need to:
- Stop smoking
- Do Exercise
- Reduce weight and fats
- Control Diabetes and Blood pressure
Monitoring CABG patients with physiologic testing can help in identifying problems in grafts and reduce the need for CABG in later years of life. In exception cases, repeated CABG is necessary but can have a high risk of complication.
