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Coronary Artery Bypass Grafting Surgery

Coronary Artery Disease (CAD)

Coronary arteries are the blood vessels that supply pure oxygenated blood and nutrients to the heart. Some inappropriate lifestyle habits like excess intake of fatty foods or alcohol may cause coronary artery diseases. When fatty material gets deposited along the coronary artery wall it narrows the artery & reduces the supply of oxygenated blood. It results in atherosclerosis. The narrowing of blood vessels may also cause coronary thrombosis, which may later cause acute coronary syndrome. The medical condition is treated with the procedure called Coronary artery bypass graft surgery (CABG).

Coronary Artery Bypass Graft Surgery

What is Coronary Artery Bypass Graft Surgery?

CABG surgery or Coronary artery bypass graft surgery involves the removal of a blood vessel from a different part of the body, either from the chest, leg or an arm, and placed around the area of the blocked coronary artery. The purpose of the surgery is to resume the flow of oxygenated blood to the heart by creating a new pathway. CABG improves the flow and treats coronary artery disease.

Eligibility for CABG

cabg-surgery-eligibility

 

Coronary artery bypass grafting is recommended for::

  • Coronary artery bypass grafting is performed to treat people with coronary heart disease or coronary artery disease. This disease leads to severe heart attacks, therefore, CABG is done to treat blocked arteries, which ultimately reduces cardiac-related mortality.
  • If the patient’s heart pump rate is weak due to blockage in the large coronary artery then doctor may recommend CABG.
  • If other treatments such as medicines or certain dietary or lifestyle changes have not worked then CABG is done.
  • Earlier if doctor has used percutaneous coronary intervention (PCI) or coronary angioplasty to treat blockages but wasn’t successful.
  • Doctor may recommend CABG looking into other factors like the severity of CHD symptoms, location of blockages, response to the other treatments and health of the patient.

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CABG Procedures

CABG surgery is a type of open heart surgery performed by Cardiothoracic surgeons. A healthy blood vessel from different part of body like leg, forearm, chest or wrist is used and attached to the coronary artery to create an alternate channel for smooth blood flow. It enables oxygenated blood to reach the heart muscle.

Before the procedure, the medical team will monitor the patient’s blood pressure, heart rhythm, and blood oxygen levels. With the patient under general anesthesia, the surgeon will make an incision in the middle of the chest and cut through the breastbone to spread apart the rib cage. After sternotomy, the surgeon next cuts through sac type lining or the pericardium to access the heart for further surgery. Coronary arteries are present on both the front & back portion of the heart.

The procedure may involve diverting left internal thoracic artery to;

1) the left anterior descending branch of left main coronary artery or

2) harvesting great saphenous vein of the leg or

3) joining the proximal end to the aorta or one of its major branches

4) diverting to the distal end to immediately beyond a partially obstructed(50% to 99% ) target vessel.

The surgeon removes a piece of healthy blood vessel or graft from ‘leg, forearm or chest’, makes a tiny hole just below the blockage in the affected coronary artery and sews the graft into the opening. A new route or channel is ready between oxygenated blood and the heart. Now the surgeon will repeat this bypass procedure to treat other affected arteries to enable blood flow.

The surgery lasts for 4 to 5 hours which again depends on the number of blocked arteries. After the surgery the doctor removes the heart-lung machine and the heart starts beating on its own and the flow is normal.

Beating heart bypass surgery’ procedure is performed while the heart is still beating, there is no need of the heart-lung machine during surgery.

Types of Coronary Artery Bypass Grafts

Internal mammary arteries or internal thoracic arteries have shown the best long-term results. These arteries are located in the chest, which are accessible through a primary incision. They are oxygen-rich arteries that can be kept intact at their origin. During surgery, the arteries are sewn to the site just below the blocked coronary artery.

Saphenous veins are harvested from the patient’s leg and again sewn from the aorta to the site just below the blocked coronary artery. A minimally invasive technique is used to remove the vein for less scarring and quick recovery.

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The arteries, ulnar & radial, are located in the lower part of the arm. Ulnar artery has an adequate blood flow so it is considered appropriate to be used used as a graft. Preoperative and intraoperative tests are performed before the usage. This bypass graft is not considered for patients having certain conditions like Raynaud’s, carpal tunnel syndrome, or painful fingers in cold air.

The grafts such as a Gastroepiploic artery to the stomach and the inferior epigastric artery to the abdominal wall are less common procedures.

Recovery After Surgery

 

recovery-after-CABG-surgery

 

The patient is transferred to the ICU for 4-5 day. The doctor keeps track of the vital signs and monitors the pulse, heart sound, blood pressure and oxygen. It may take 2-3 months to fully recover from the surgery. If the surgery is a minimally invasive one, then recovery will be quicker. The patient has to strictly follow the doctor’s instructions and follow-up care. He can get back to routine activities like driving in 6-8 weeks.

Risks Associated with CABG Surgery

While conventional CABG is performed by splitting open the sternum or breastbone, minimally invasive coronary artery bypass graft surgery (MICS CABG) is completely safe & has revolutionized the way CABG is performed. MICS CABG is relatively new & an advanced technique which involves approaching the heart through small incisions made on the side of left chest. This way the chest is entered in-between the ribs without having to split muscle or cut through bones. Apart from this, remaining CABG procedure is alike. However, risks & complications associated with both these approaches would vary due to the difference in the type of incisions. MICS CABG involves highly advanced techniques & instrumentation during operation which is performed very safely.

Commons risks & complications associated with CABG surgery include the following.

  • Bleeding
  • Arrhythmias (heart rhythm irregularities)
  • Stroke
  • Kidney Problems
  • Heart Attack (when blood clots break loose following surgery)
  • Memory Loss or trouble with Clarity in Thinking (improves within 6 – 12 months)
  • Infections at the site of incisions

Risks of developing complications are normally low with MICS CABG, but this invariably depends upon the patient’s health prior to undergoing surgery. Cardiac surgeons usually give an idea of likelihood of experiencing risks & complications to patients during discussion prior to CABG surgery. Moreover, risk of complications is typically higher when CABG surgery is performed as an emergency procedure or when the heart patient is having other medical conditions like PAD (peripheral artery disease) (blocked arteries in legs), diabetes, kidney disease or emphysema.

Affordable Coronary Artery Bypass Graft Surgery

Most people around the world are unable to seek timely treatment for coronary artery disease due to the exorbitant costs involved. Especially, undergoing CABG surgery in developed countries like United Kingdom, Canada & United States is beyond the reach of an ordinary person. This is one of the prime reasons as to why global medical tourism is flourishing by the day. More & more people nowadays are willing to travel across the globe in search of standard quality of affordable healthcare solutions. Over the past few decades India has geared up for this challenge. Healthcare structure in India is robust & comprises of some of the best globally recognized doctors including cardiac surgeons & internationally accredited hospital facilities managed by highly skilled English speaking professional staff. Along with this, cost of medical procedures including CABG surgery in India is highly reasonable. Cost of CABG surgery in India is in fact just a fraction of what an international patient will have to pay in developed countries, with outcomes at par with the best in the world.

IndianMedTrip is the fastest growing healthcare service provider in South Asia. They are associated with top cardiac surgeons & the best accredited multispecialty hospitals in the country. They are well placed to offer the best & the most competitive CABG surgery packages to people from all around the world without any waiting period. Seamless services offered by IndianMedTrip cover every minute detail of overseas patient’s requirements so as to give them a totally hassle-free healthcare experience. Call on us now or drop a mail, for free online consultation regarding your coronary heart disease problem.

To learn more and for complete detail of Coronary Artery Bypass Grafting Surgery please contact with IndianMedTrip. E-mail us at info@indianmedtrip.com

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