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A very popular treatment used to treat coronary artery disease is coronary artery bypass graft surgery (CABG). The blood channels that carry oxygen and nutrients to the heart muscle are known as the coronary arteries, and coronary artery disease (CAD) is the narrowing of these blood vessels. Fatty substance accumulating in the artery walls is what leads to CAD. This accumulation makes the inside of the arteries smaller, which reduces the amount of oxygen-rich blood that can reach the heart muscle.

Bypassing the blocked section of the coronary artery with a piece of a healthy blood vessel from another part of your body is one method of treating the blocked or restricted arteries. Pieces of a leg vein or a chest artery might be utilized as blood arteries, or grafts, during the bypass treatment. Another option is to use an artery from your wrist. The graft is attached here with one end above the blockage and the other below the blockage your doctor. To get to the heart muscle, blood travels via the new graft and around the obstruction. Coronary artery bypass surgery is what this is.

Your doctor usually creates a significant chest incision to bypass the blocked coronary artery while also momentarily stopping the heart. Your doctor would split the breastbone (sternum), which opens the chest, in half lengthwise. Your doctor will expose the heart and inserts tubes so that a heart-lung bypass machine can pump blood across the body once it has been exposed. Blood must be pumped via the bypass machine while the heart is halted.

Although less invasive techniques to bypass blocked coronary arteries have been developed, open heart surgery is still regularly performed and is frequently preferred in many situations. Off-pump surgeries, in which the heart is not required to be halted, were developed in the 1990s. Other minimally invasive techniques may be employed, including robotic treatments and keyhole surgery (both of which are performed through very small incisions).

Why it's carried out

•        The heart requires a steady flow of blood, much like every other organ in the body.

•        The left and right coronary arteries, 2 big blood vessels, provide the blood for this.

•        These arteries are susceptible to narrowing and hardening as a result of the accumulation of plaques, which are fatty deposits.

•        Atherosclerosis is the term for this process.

•        People with coronary heart disease have atherosclerosis of the coronary arteries.

•        As you become older, your risk of developing coronary heart disease rises.

•        Additionally, you're considerably more likely to be impacted if

•        you smoke

•        you're overweight or obese

•        you have a high-fat diet

Angina, a type of chest pain brought on by a restriction in the flow of oxygen-rich blood to the heart, can be brought on by coronary heart disease.

While medication is frequently used to treat angina, severe cases may necessitate a coronary artery bypass graft to increase the heart's blood flow.

The potential for one of the coronary artery plaques to rupture (split), resulting in the formation of a blood clot, is another danger related to coronary heart disease.

A heart attack may occur if the blood clot restricts the heart's ability to receive blood.

Your risk of suffering a heart attack may be decreased by a coronary artery bypass graft.


In order to cure a blockage or narrowing of one or more coronary arteries and restore the blood flow to your heart muscle, your doctor may perform coronary artery bypass graft surgery (CABG).

Coronary artery disease symptoms can include:

•        Chest pain

•        Fatigue (severe tiredness)

•        Palpitations

•        Abnormal heart rhythms

•        Shortness of breath

•        Swelling in the hands and feet

•        Indigestion

Even though you might not experience any symptoms in the early stages of coronary artery disease, the condition will worsen until there is enough arterial blockage to result in symptoms and issues. You could experience a heart attack if the blood flow to your heart muscle keeps getting worse due to a coronary artery that is becoming increasingly blocked. The tissue of the heart muscle dies if the blood flow cannot be restored to the specific place that is injured.

Your doctor might advise CABG surgery for additional factors.

How to get ready for coronary artery bypass surgery?

•        You can ask questions while your doctor walks you through the procedure.

•        To grant your assent to the test, you will be required to sign a consent form. Carefully read the paperwork, and if anything is unclear, ask questions.

•        Before having the treatment, your doctor will evaluate your medical history and perform a full physical check to ensure that you are otherwise in good health. You could require diagnostic testing such as blood tests.

•        You will be instructed to abstain from food and liquids for eight hours prior to the surgery, usually after midnight.

•        The night before and the morning of the procedure, you might be instructed to take a shower using a particular soap or cleaner.

•        If you suspect you could be pregnant, let your doctor know.

•        If you are sensitive to or allergic to any medications, iodine, latex, tape, or anesthetic medications, let your doctor know right once (local and general).

•        Be sure to let your doctor know if you take any prescription or over-the-counter medications, vitamins, herbs, or dietary supplements.

•        Be sure to let your doctor know if you've ever experienced bleeding issues or if you take any aspirin, blood-thinning medications, or other drugs that alter blood coagulation. It's possible that some of these medications must be stopped prior to the surgery.

•        In order to determine how long it takes for your blood to clot, your doctor may perform blood tests prior to the treatment.

• If you smoke, you must stop as soon as you can quit;

• If you have a pacemaker or any other implanted cardiac device, let your doctor know. This will boost your general health and increase the likelihood that you will recover fully following surgery. Your doctor may give you additional preparation instructions depending on your health.

What happens during coronary artery bypass?

A hospital stay is necessary after coronary artery bypass graft surgery (CABG). Depending on your health and your doctor's preferences, the procedure could change.

Generally, CABG follows this process:

1. Any jewelry or other items that can obstruct the treatment will need to be taken off.

2. You'll put on a hospital gown and urinate first.

3. On a surgical table, you will lie on your back.

4. Throughout the procedure, the anesthesiologist will continuously check your heart rate, blood pressure, respiration, and blood oxygen level. After being deeply sedated, a breathing tube would be placed in your throat, and you'll be attached to a ventilator so it may take care of your breathing while the surgery is being done.

5. An intravenous (IV) line will be inserted into your arm or hand by a medical expert. You will also have other catheters inserted in your neck and wrist to collect blood samples and monitor your heart and blood pressure.

6. Your bladder will be inserted with a catheter to drain your urine.

7. An antiseptic solution will be used to clean the skin surrounding the surgery site.

8. Following the placement of all the tubes and monitors, your doctor will make cuts in one or both of your wrists or one or both of your legs to gain access to the blood vessel(s) that will be used for the grafts. He or she will cut out the vessel(s) and then sutures the wound (s).

9. The surgeon will make a cut from just above the navel to just below Adam's apple.

10. The sternum (breastbone) will be split longitudinally by the physician. To reveal your heart, he or she would split the breastbone in half and spread it apart.

Coronary artery bypass graft surgery--on-pump procedure

1.       Your doctor will need to momentarily stop your heart in order to stitch the grafts onto the extremely narrow coronary arteries. A heart-lung bypass machine will pump blood through your body once tubes are inserted into the heart.

2.       After the bypass machine has been used to pump the blood, your doctor will stop the heart by giving it a cold solution injection.

3.       3. After the heart has stopped, the surgeon will perform the bypass graft surgery by stitching one end of a vein portion over a tiny opening created in the aorta and the other end over a tiny opening created in the coronary artery right below the obstruction. The lower end of the internal mammary artery will be removed from inside your chest and sewed over a hole made in the coronary artery below the blockage if your doctor decides to utilize it as a bypass transplant.

4.       Depending on the number and location of your blockages, you might require more than one bypass graft. As blood flows via each graft after it has been finished, the doctor will carefully inspect each one to make sure it is functioning.

5.       After the bypass grafts have been examined, the physician will remove the tubes connecting the machine and permit the blood to return to your heart through the bypass machine. Your heart may start beating again on its own or it might be given a gentle electric shock.

6.       Your physician might implant temporary wires for cardiac pacing. If necessary, a pacemaker can be connected to these wires so that during the initial phase of recuperation, your heart can be paced.


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