How Coronary artery bypass surgery works

RETINA - রেটিনা

15 Jan 201704:25

Summary

TLDRCoronary artery bypass graft (CABG) is a surgical procedure for severe coronary artery disease, where a healthy blood vessel graft is used to bypass blocked arteries, improving heart muscle circulation. The surgery involves general anesthesia, a cardiopulmonary bypass pump, and may use the internal thoracic artery or saphenous vein for grafts. Recent advancements include off-pump and minimally invasive techniques. Post-surgery, patients are closely monitored in the ICU, with temporary devices in place for recovery.

Takeaways

💡 Coronary artery bypass graft (CABG) surgery is performed to improve blood circulation to the heart muscle in patients with severe coronary artery disease.
🔍 During CABG, a healthy artery or vein from another part of the body is grafted to the blocked coronary artery to bypass the blockage and supply oxygen-rich blood to the heart muscle.
💊 Prior to surgery, an intravenous line is started and patients may receive medication to help them relax.
😴 CABG procedures are conducted under general anesthesia, which puts the patient to sleep during the operation.
🌬️ A breathing tube is inserted through the mouth to assist with breathing, and a catheter is placed in the bladder to drain urine.
⏱ The surgery typically takes between three to six hours to complete.
🔪 In conventional bypass surgery, an incision is made over the breastbone, and the sternum is cut to access the heart.
🔄 A cardiopulmonary bypass pump, or heart-lung machine, is used to temporarily perform the functions of the heart and lungs, allowing the heart to be stopped for graft placement.
🔍 Two common blood vessels are used for grafts: the internal thoracic artery in the chest or the saphenous vein in the leg.
📌 For grafts, the surgeon sews one end to the aorta or subclavian artery and the other end to the narrowed artery beyond the blockage.
💓 Once the grafts are in place, the surgeon uses electrical signals to restore the heartbeat and may attach a temporary pacemaker.
🛌 Post-surgery, patients are taken to the intensive care unit where their heart activity is monitored, and devices like chest tubes and breathing tubes are gradually removed as they recover.

Q & A

What is a coronary artery bypass graft (CABG) surgery?
-CABG surgery is a procedure performed to improve blood circulation to the heart muscle in individuals with severe coronary artery disease. It involves grafting a healthy artery or vein from another part of the body to bypass the blocked coronary artery, thus restoring the flow of oxygen-rich blood to the heart muscle.
How many coronary arteries can be bypassed in a single CABG operation?
-During a single CABG operation, one or more coronary arteries may be bypassed, depending on the extent of the blockages and the patient's condition.
What preparations are made before CABG surgery?
-Before the surgery, an intravenous line is started, and the patient may be given medication to help them relax. The procedure is performed under general anesthesia, which puts the patient to sleep for the duration of the operation.
What is the role of the cardiopulmonary bypass pump during CABG surgery?
-The cardiopulmonary bypass pump, also known as the heart-lung machine, temporarily takes over the functions of the heart and lungs during the surgery, allowing the heart to be stopped while the surgeon sews the grafts into place.
What are the two types of blood vessels typically used for grafts in CABG surgery?
-The two types of blood vessels typically used for grafts in CABG surgery are the internal thoracic artery in the chest and the saphenous vein in the leg.
How is the internal thoracic artery graft connected during CABG surgery?
-For the internal thoracic artery graft, the surgeon leaves the upper end attached to the subclavian artery and diverts the lower end from the chest wall to the coronary artery just beyond the blockage, then sews the graft into place.
What is the process for attaching a saphenous vein graft during CABG surgery?
-For the saphenous vein graft, the surgeon sutures one end to the aorta and the other end to the narrowed artery just beyond the blockage.
What is the purpose of the temporary pacemaker attached to the heart after the grafts are in place?
-The temporary pacemaker is attached to the heart to help restore the heartbeat and ensure the heart is beating normally after the grafts have been secured.
What are the two alternative types of CABG procedures that have been developed?
-The two alternative types of CABG procedures are off-pump CABG, also known as beating heart bypass grafting, and minimally invasive bypass surgery, which uses specially designed instruments inserted through small incisions or ports in the chest.
What happens after the CABG surgery is completed?
-After the surgery, the patient is taken to the intensive care unit where their heart activity is monitored. Devices such as a chest tube for draining excess blood and air, a breathing tube, and a bladder catheter are used during the recovery period, and are gradually removed over the next few days.
How long does a conventional CABG surgery typically take?
-A conventional CABG surgery generally takes between three to six hours.

Outlines

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💓 Coronary Artery Bypass Graft Surgery Overview

This paragraph provides an overview of coronary artery bypass graft (CABG) surgery, a procedure used to enhance blood circulation to the heart in patients with severe coronary artery disease. The surgery involves grafting a healthy artery or vein to bypass the blocked coronary artery, allowing oxygen-rich blood to reach the heart muscle. The paragraph explains the pre-surgery preparations, the anesthesia process, and the use of a cardiopulmonary bypass pump during the operation. It also describes the incision and the process of grafting, including the use of the internal thoracic artery or saphenous vein. The paragraph concludes with the steps taken at the end of the surgery, such as restoring heartbeat, attaching a temporary pacemaker, and closing the incision.

Mindmap

Keywords

💡Coronary Artery Bypass Graft (CABG)

CABG is a surgical procedure used to treat severe coronary artery disease by improving blood circulation to the heart. The term refers to the process of grafting a healthy artery or vein onto a blocked coronary artery to bypass the obstruction, allowing oxygen-rich blood to reach the heart muscle. In the script, CABG is the central theme, with the procedure described in detail, including the use of a cardiopulmonary bypass pump and the grafting of blood vessels.

💡Intravenous Line

An intravenous line, or IV, is a medical device used to administer fluids, medications, or nutrients directly into the bloodstream. In the context of the video, an IV line is started before CABG surgery to administer medication to help the patient relax and prepare for the operation.

💡General Anesthesia

General anesthesia is a type of anesthesia that induces a state of unconsciousness, preventing the patient from feeling pain during surgery. The script mentions that CABG procedures are performed under general anesthesia, which puts the patient to sleep for the duration of the operation.

💡Breathing Tube

A breathing tube, also known as an endotracheal tube, is inserted through the mouth and into the throat to assist with breathing during surgery. The script describes its use in CABG surgery to ensure the patient is able to breathe while under general anesthesia.

💡Catheter

A catheter is a flexible tube that can be inserted into the body to drain fluids. In the script, a catheter is placed in the patient's bladder to drain urine during the CABG procedure.

💡Cardiopulmonary Bypass Pump

A cardiopulmonary bypass pump, also known as a heart-lung machine, temporarily takes over the functions of the heart and lungs during surgery. The script explains that this machine is used in conventional CABG surgery to allow the heart to be stopped while the surgeon sews the grafts into place.

💡Graft

In the context of CABG, a graft refers to a healthy blood vessel that is used to bypass a blocked coronary artery. The script mentions two types of blood vessels typically used for grafts: the internal thoracic artery and the saphenous vein.

💡Subclavian Artery

The subclavian artery is a major blood vessel that supplies blood to the upper body. In the script, it is mentioned in relation to the internal thoracic artery graft, where the upper end of the graft is left attached to the subclavian artery.

💡Aorta

The aorta is the main and largest artery in the body, carrying oxygenated blood from the heart to the rest of the body. In the script, it is mentioned as the point where one end of the saphenous vein graft is sutured during CABG surgery.

💡Off-Pump CABG

Off-pump CABG, also known as beating heart bypass grafting, is a variation of the traditional CABG procedure where the heart is not stopped, and a heart-lung machine is not used. Instead, a mechanical device is used to steady the part of the heart being worked on. The script describes this as an alternative to conventional CABG.

💡Minimally Invasive Bypass Surgery

Minimally invasive bypass surgery is a less invasive alternative to traditional CABG, performed through small incisions or ports in the chest using specially designed instruments. The script mentions that this type of procedure may sometimes require the use of a heart-lung machine.

Highlights

A coronary artery bypass graft (CABG) is performed to improve circulation to the heart muscle in people with severe coronary artery disease.

During CABG, a healthy artery or vein is grafted to bypass the blocked coronary artery, ensuring oxygen-rich blood reaches the heart muscle.

CABG can bypass one or more coronary arteries in a single operation.

Pre-surgery preparation includes starting an intravenous line and administering medication to help the patient relax.

CABG is performed under general anesthesia, with the patient asleep throughout the operation.

A breathing tube is inserted to assist with breathing during the surgery.

A catheter is placed to drain urine, ensuring patient comfort and monitoring.

The surgery typically takes three to six hours to complete.

Conventional bypass surgery involves an incision over the breastbone and the use of a cardiopulmonary bypass pump.

The heart-lung machine temporarily takes over the functions of the heart and lungs, allowing the surgeon to work on a stopped heart.

Two types of blood vessels are commonly used for grafts: the internal thoracic artery or the saphenous vein.

For the internal thoracic artery graft, the upper end remains attached to the subclavian artery while the lower end is diverted to bypass the blockage.

Saphenous vein grafts are sutured to the aorta and the narrowed artery beyond the blockage.

Once grafts are in place, electrical signals are used to restore the heartbeat, and a temporary pacemaker may be attached.

After the surgery, the patient is taken to the intensive care unit where heart activity is closely monitored.

Pacing wires may be used to control heart rate temporarily post-surgery.

A chest tube is placed to drain excess blood and air, aiding in recovery.

Off-pump and minimally invasive bypass surgeries are recent developments, offering alternatives to traditional CABG.

Off-pump CABG, or beating heart bypass grafting, does not use a heart-lung machine and steadies the heart with a mechanical device.

Minimally invasive bypass procedures use small incisions and specially designed instruments, sometimes with the aid of a heart-lung machine.

Post-surgery recovery includes the gradual removal of devices such as the breathing tube, oxygen mask, and bladder catheter over three to four days.