What Is Coronary Artery Bypass Surgery?
Also known by the names of coronary artery bypass graft, CABG or colloquially heart bypass surgery, it is the surgical method of redirecting the blood flow in the coronary arteries in order for a smooth blood flow and good functioning of the heart. The two coronary arteries, which are branches of the aorta further divide into numerous arteries and are named according to the site they are supplying. Due to a few etiological factors, deposits known as plaque may accumulate in the coronary artery as a result of which the lumen of the artery keeps getting narrower. This in turn leads to less amount of blood passing through the artery resulting into reduced blood supply to the affected part. Hence it becomes mandatory to remove the plaque or give blood a new pathway to flow.
Causes OF Coronary Artery Blockage:
- Excessive consumption of cholesterol in the diet. This hold true for LDL and VLDL levels. These accumulate in the lumen of the arteries thereby blocking them majorly
- Smoking and alcohol consumption add to the plaque formation in the blockages
- Lack of physical exercise, sedentary lifestyle
Signs and Symptoms of Coronary Artery Blockage:
- Chest pain
- Heaviness and discomfort in the chest
- Burning and squeezing sensation in the chest
- Shortness of breath, dizziness
- Mental confusion, nausea, vomiting
Diagnosis of Coronary Artery Blockage:
A complete medical history needs to be jotted down along with a thorough physical examination of the patient. In addition to these, a few tests are needed to be run as follows:
- Electrocardiogram: This test monitors the electrical activity of the heart and how well the signals travel through the heart.
- Echocardiogram: This method uses ultrasound waves to create a picture of the heart and diagnose each part in terms of its functioning.
- Stress test: This test is done to measure the stress caused on the heart while performing certain physical activities and while at rest. The patient is made to walk at different speeds on a treadmill and then ride a stationary bike. The electrical activity of the heart is monitored at each of these activities and hence a total evaluation of the entire activity can be done.
- ardiac catherization: In this method, a dye is injected into the artery with the help of a catheter. This dye settles on the blockages making them radio opaque. Then a series of images are taken in order to study the blockages determining their extent, number and deciding on the treatment plan accordingly.
- eart CT scan: A computed tomography is done to assess the degree of calcium content in the heart blockages.
Types of Coronary Artery Bypass Surgery:
Depending upon the number of arteries involved in the bypass procedure, the method can be of the following types:
Single (1), double (2), triple (3), quadruple (4), quintuple (5) bypass surgery
For example, a single coronary artery is by passed in a single type of surgery, a triple would involve bypassing three coronary arteries.
Treatment Procedures for Coronary Artery Bypass Surgery:
Coronary artery bypass grafting (CABG) is used to treat people who have severe coronary heart disease (CHD) that could lead to a heart attack. CABG also may be used to treat people who have heart damage following a heart attack but still have blocked arteries. A CABG can also be recommended when other factors such as change in the lifestyle or course of medications also have not worked well. CABG can be the ideal option if you have severe blockages in the large coronary arteries that supply a major part of the heart muscle with blood nutrients; especially when the normal pumping of the heart has already been damaged or weakened. It is also the last resort when it becomes difficult to manage heart with angioplasty. It is decided when the following factors are taken into consideration:
- The presence and severity of CHD symptoms
- The severity and location of blockages in your coronary arteries
- Your response to other treatments
- Your quality of life
- Any other medical problems you have
- CABG may be done on an emergency basis, such as during a heart attack.
Types of Coronary Artery Bypass Grafting:
- Traditional Coronary Artery Bypass Grafting: This is the most common type of coronary artery bypass grafting (CABG). It is used when at least one major artery needs to be bypassed. During the surgery, the chest bone is opened to access the heart. Medicines are given to stop the heart, and a heart-lung bypass machine is used to keep blood and oxygen moving throughout the body during surgery. This allows the surgeon to operate on a still heart. After surgery, blood flow to the heart is restored. Usually, the heart starts beating again on its own. In some cases, mild electric shocks are used to restart the heart.
- Off-Pump Coronary Artery Bypass Grafting: This type of CABG is similar to traditional CABG because the chest bone is opened to access the heart. However, the heart isnt stopped, and a heart-lung bypass machine isnt used. Off-pump CABG is sometimes called as beating heart bypass grafting.
- Minimally Invasive Direct Coronary Artery Bypass Grafting: This surgery is similar to off-pump CABG. However, instead of a large incision (cut) to open the chest bone, several small incisions are made on the left side of the chest between the ribs. This type of surgery mainly is used for bypassing the blood vessels in front of the heart. It is a fairly new procedure that is done less often than the other types of CABG. This type of CABG is not for everybody, especially if more than one or two coronary arteries need to be bypassed.
- Robot-assisted technique: This type of procedure allows for even smaller, keyhole-sized incisions. A small video camera is inserted in one incision to show the heart, while the surgeon uses remote-controlled surgical instruments to do the surgery. A heart-lung bypass machine is sometimes used during this procedure.
Complications And Risk Factors Associated With Coronary Artery Bypass Surgery:
Complications do occur with a coronary artery bypass surgery considering it is an open surgery. Risk of developing complications depends upon the overall health of the patient as well. Complications encountered at the time of surgery or post surgery are as follows:
- Uncontrolled bleeding
- Infections and scarring of the chest wounds
- Irregular heart beat and rhythm
- Memory loss, trouble with thinking clearly
- Kidney problems such as difficulty in passing urine, painful urination
- Heart attack; if the blood clot breaks loose after the surgery
- Emphysema, diabetes, increased blood pressure, kidney diseases, peripheral artery disease, smoking, alcohol, high cholesterol diet further complicate and pose a threat for the surgical procedure
- Obstructive sleep apnea, emotional stress also add to further complexity
Am I Good Candidate For Coronary Artery Bypass Surgery?
If any of the following symptoms is a worry for you, you are an ideal case for undergoing a coronary artery bypass surgery:
- Severe chest pain, squeezing in the heart
- Symptoms worsen in the morning hours
- Left side id=s more prone for the discomfort
- You’ve suffered from a recent heart attack and still feel the symptoms have not subsided
- Angioplasty is not recommended in your case
You are required to stay in the intensive care unit for a period of 2 to 3 days where your vitals are monitored such as heart rate, blood pressure, breathing and temperature. A complete recovery may take 6 to 8 weeks for you to get back to your normal routine.
A coronary artery bypass surgery has a 95 percent success rate. In about 2 percent of cases, chances of immediate death can be seen.
Benefits of Coronary Artery Bypass Surgery:
A coronary artery bypass surgery will help you in the following ways:
- Improve your quality of life and decrease angina and other coronary heart disease symptoms
- Allow you to resume a more active lifestyle
- Improve the pumping action of your heart if at all it has been damaged by a heart attack
- Lowers the risk of a heart attack in future since all blockages are by passed
- Highly improves your chance of survival
A surgery for CABG would cost you around 1.25 to 2.25 lakh in India, including the hospital stay and the medications. This is roughly 35 percent lesser than the charges you would be expected to pay in the UK/US/Australia
Why choose India?
India is one of the leading countries in the world in the field of cardiac surgery. We at MedcureIndia are affiliated with the most renowned cardiac centers of the country and aim at directing our clients to these institutes with the best treatment outcomes guaranteed.