Heart Bypass Surgery (CABG)

Summary

A Coronary Artery Bypass Graft (CABG) is a surgical procedure to enhance heart circulation in patients with severe coronary artery disease. It involves grafting a healthy artery or vein from another body part to bypass the blocked coronary artery, ensuring oxygen-rich blood reaches the heart muscle. The surgery, performed under general anesthesia, may use the internal thoracic artery or saphenous vein for grafting and can be conducted on-pump or off-pump. Post-surgery, patients are closely monitored in ICU, with temporary devices in place for recovery.

Takeaways

• 🩺 A coronary artery bypass graft (CABG) is a surgical procedure to improve blood circulation to the heart muscle in patients with severe coronary artery disease.
• 🔁 The procedure involves grafting a healthy blood vessel from another part of the body to bypass the blocked coronary artery.
• 💉 Before surgery, patients receive an intravenous line, relaxation medication, and are placed under general anesthesia.
• 🌐 The surgery may involve bypassing one or more coronary arteries in a single operation.
• ⏱ CABG surgery typically takes three to six hours to complete.
• 🔪 The surgeon makes an incision in the chest and uses a heart-lung machine to temporarily take over the functions of the heart and lungs.
• 🩸 Two types of blood vessels are commonly used for grafts: the internal thoracic artery or the saphenous vein.
• 🛠️ Off-pump and minimally invasive CABG procedures have been developed as alternatives to conventional bypass surgery.
• 🛑 In off-pump CABG, the heart is not stopped, and a heart-lung machine is not used; instead, a mechanical device stabilizes the heart.
• 🏥 After surgery, patients are closely monitored in the ICU, with devices in place to support heart function and drain excess fluids.

Q & A

What is a coronary artery bypass graft (CABG)?

A coronary artery bypass graft (CABG) is a surgical procedure performed to improve circulation to the heart muscle in people with severe coronary artery disease by using a healthy artery or vein from another part of the body to bypass the blocked coronary artery.

Why is CABG performed?

CABG is performed to improve blood flow and oxygen supply to the heart muscle in patients with severe coronary artery disease, where the coronary arteries are blocked or narrowed.

What happens during a CABG procedure?

During a CABG, a healthy blood vessel from another part of the body is grafted to the blocked coronary artery, bypassing the blockage and allowing oxygen-rich blood to reach the heart muscle.

What types of vessels are typically used for grafts in a CABG?

Typically, the internal thoracic artery in the chest or the saphenous vein in the leg are used for grafts in a CABG.

How does the heart-lung machine function during a CABG?

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 is off-pump CABG, and how does it differ from conventional CABG?

Off-pump CABG, also known as beating heart bypass grafting, is a 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 where grafting is being done.

What is minimally invasive bypass surgery, and how does it compare to traditional CABG?

Minimally invasive bypass surgery is a type of CABG performed through small incisions or ports in the chest using specially designed instruments, which can sometimes require a heart-lung machine and is less invasive than traditional open-chest CABG.

What preparations are made before a CABG surgery?

Before CABG surgery, an intravenous line is started, patients may be given medication to help them relax, and general anesthesia is administered to put the patient to sleep for the duration of the operation.

What is the typical duration of a CABG surgery?

Coronary artery bypass surgery generally takes three to six hours to complete.

What happens after a CABG surgery?

After surgery, patients are taken to the intensive care unit where their heart activity is monitored. Devices such as a temporary pacemaker, chest tube, and bladder catheter are used during the initial recovery period.

How long does it typically take for a patient to recover after a CABG?

Patients typically spend three to four days recovering in the hospital, during which time various devices are gradually removed as the patient's condition improves.