The treatment procedure for overcoming coronary artery disease is known as coronary artery bypass graft (CABG). Coronary arteries are the blood vessels that provide blood and oxygen to the muscles of the heart. Coronary artery disease (CAD) occurs when substances known as cholesterol plaques build up inside the arteries and block the flow of blood. Subsequently, the heart muscle cannot get enough oxygen and dies—this is known as myocardial infarction or heart attack.
One of the treatment options for CAD is CABG, whereby a healthy vein or an artery from the patient’s own body is connected to the blocked coronary artery in a way that the blood bypasses the blocked portion of the artery. In this way, a new route is established for the oxygen-rich blood to the heart muscle. Although you should consult the best cardiologist in Lahore before you opt for any treatments.
What are the goals of CABG?
The goal of surgery is to improve the quality of life, as well as the blood flow to the heart to combat the symptoms of CAD, including angina. CABG allows the patient to resume their activities of daily living, and have a more active lifestyle.
If the pumping action of the heart is affected by heart attack, CABG helps to improve it. Moreover, it decreases the chance of another heart attack. Later after the surgery if the graft becomes blocked, another graft can be put in.
What are the types of CABG?
There are multiple types of graft surgeries. Read on to know more about the types of CABG:
Traditional Coronary Artery Bypass Graft
This procedure is typically done the most often, especially when a major artery is involved. The chest bone is opened to access the heart and the heart is stopped through medication. Instead of the heart, a heart-lung machine is used to keep the oxygenated blood moving throughout the body during the surgery.
When the grafting is complete, the patient is put off the heart-lung machine and the heart is restarted.
Off-pump Coronary Artery Bypass
This is also known as the beating heart bypass grafting because the heart is not stopped in this procedure; as the name implied, there is no heart-lung pump involved in this type of surgery. However, the chest bone is still opened to access the heart.
Minimally invasive direct coronary artery bypass grafting
In this type of surgery, there is no pump involved, and neither is a large incision to cut open the chest. Instead, this off-pump surgery is performed with the help of several small incisions, made between the ribs on the left side. This is a newer type of CABG that’s mainly used for bypassing the diseased blood vessels present on the front of the heart. However, this procedure cannot be done if more than one coronary artery is involved.
In-hospital care involves staying in the ICU for a couple of days, followed by room stay for 3 to 5 days. Once you are discharged, your healthcare provider will give you instructions about wound care. Additional instructions include how to recognize signs of infections and complications, when to schedule follow-up appointments and when to call the doctor right away.
The side effects of surgery will be felt up to six weeks post-procedure. These include discomfort at the site of the stitches, itching in the healing incisions, fatigue, depression, and mood swings. Additionally, there can be problems in sleeping with loss of appetite and weight loss. There can be discomfort and swelling at the site of graft removal (mostly the leg), along with tightness of shoulders and upper back muscles.
What are the risks of CABG?
Coronary Artery Bypass Graft is an open-heart surgery, and as such can have complications both during and after the procedure. The possible complications include wound related bleeding, or wound infection. Surgical wounds can become infected if there is poor post-operative care, or poor wound healing as in case of uncontrolled diabetes. Heart rhythm irregularities i.e. arrhythmias can become a complication of CABG. Memory troubles or problems thinking clearly are often a consequence of the surgery, usually due to the anesthetic drugs. These troubles improve within six to twelve months. Another complication of the surgical procedure is clot formation, which if turns loose, can cause a stroke or a heart attack.
These complications can be avoided with good post-operative care, and good health in general before surgery. On the other hand, the probability of complications arising is higher in patients of emphysema, diabetes, peripheral arterial disease, or kidney disease.
What to expect after the surgery?
Barring any complication, patient can expect to remain symptom-free for at least ten to fifteen years. Without lifestyle modification, even the graft can become clogged with plaques, requiring another by-pass or angioplasty.
The results as well as the long-term outcome will become better with lifestyle changes and adherence to the instructions of your healthcare provider. In general, one should quit smoking, and follow a healthy diet plan for starters. Regular exercise is necessary for heart patients, to maintain regular weight and manage stress or you may need to visit the top cardiothoracic surgeon in Lahore.