What is CABG? Type of Heart Bypass Surgery

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What is CABG?

Coronary artery bypass grafting (CABG), also known as heart bypass surgery, is a surgical procedure performed to improve the blood flow to the heart by creating a bypass around the blocked or narrowed coronary arteries (arteries supplying blood to the heart) using a graft.

CABG is used to treat coronary artery disease, which is a condition characterized by the narrowing or blockage of the coronary arteries leading to the restriction of blood flow to the heart muscle. 

Coronary artery disease develops due to the build-up of plaque in the arteries of the heart, which is a condition known as atherosclerosis, which in turn causes the narrowing or blockage of the coronary arteries. This condition may lead to symptoms like chest pain (angina), heart attacks, palpitations, irregular heart rhythms (arrhythmias), shortness of breath, fatigue, and other cardiovascular complications which could be life-threatening.

CABG is used to relieve these symptoms, restore the blood flow to the heart, and prevent the condition from turning fatal.

In this article, we will be discussing in detail about CABG.

What is the purpose of Coronary artery bypass grafting?

The primary purpose of CABG is to restore sufficient blood flow to the heart muscle, thereby relieving symptoms and reducing the risk of serious cardiovascular problems. 

CABG is generally recommended for the following reasons:

• Relieving chest pain: CABG helps in reducing or eliminating chest pain or angina caused due to restricted blood flow to the heart.
• Improving heart function: The main function of the heart is to pump blood to the rest of the body. By restoring the blood supply to the heart, CABG can help improve the pumping ability of the heart.
• Preventing heart attacks: CABG can decrease the likelihood of developing future heart attacks, which could be a life-threatening condition. ( Know more about- What is a Heart Attack ? )
• Increasing the longevity of life: In certain groups of patients, particularly those with severe CAD or left main coronary artery disease, CABG has been shown to improve survival rates.

What are the diagnostic tests done before Coronary artery bypass grafting?

Before undergoing CABG, the doctor recommends undergoing a thorough diagnostic evaluation to determine the extent of coronary artery disease and to plan the surgery. The following diagnostic tests are commonly recommended:

• Physical examination: The patient’s physical health is assessed and the symptoms of the patient are noted. The medical history of the patient is also taken down.
• Blood tests: They help in determining the general health of the patient and if the patient is fit to undergo surgery.
• Chest X-ray: It helps the doctor check the size and condition of the heart and lungs.
• Electrocardiogram (ECG or EKG): This test helps record the electrical activity of the heart to detect any abnormalities that may be present in the heart.
• Echocardiogram: This test uses ultrasound waves to create clear images of the heart, and assess the heart structure and its function.
• Stress test: This test helps the doctor evaluate how the heart performs under physical exertion like running on a treadmill or due to stress induced by a medication.
• Coronary angiography: This test involves the injection of a contrast dye into the coronary arteries through the blood vessels in the arm, leg, or groin area and viewing the flow of this dye through X-ray imaging, to pinpoint the location and severity of blockages in the heart. ( Know more about- Cost of Heart Bypass Surgery in Bangalore )

What is the procedure for Coronary artery bypass grafting?

The traditional on-pump CABG procedure is performed as follows:

• The procedure is performed under the effect of general anesthesia, which means that the patient will be put to sleep before the procedure.
• The surgeon will first make a long incision down the middle of the chest, cutting through the breastbone (sternum) to access the heart.
• In many cases, the heart is stopped, and a heart-lung machine takes over the heart’s pumping and oxygenating functions. This is known as traditional on-pump CABG.
• The surgeon will then remove a healthy blood vessel, usually from the leg (saphenous vein), arm (radial artery), or chest (internal mammary artery). This vessel is then grafted to bypass the blocked coronary artery, creating a new path for blood flow.
• After completing the grafts, the heart is restarted, and the incision is closed using stitches or staples.

The other alternative techniques that may be used by the surgeon to perform the CABG surgery include the following:

• Off-pump CABG or beating heart surgery: This procedure is performed while the heart is still beating and does not involve the use of a heart-lung bypass machine. Certain stabilizing devices are used to immobilize the specific heart area where the surgeon is operating.
• Minimally invasive direct coronary artery bypass surgery: This is a less invasive treatment option in which small incisions are made between the ribs rather than cutting through the breastbone. Specialized instruments and a thoracoscope containing a camera on one end are used to perform the grafting.
• Robot-assisted CABG: It is a minimally-invasive surgery performed using robotic arms that are controlled by the surgeon through a video camera attached to a monitor screen. The technique offers more precision, less trauma, and faster recovery.

How is the aftercare following Coronary artery bypass grafting?

The following are the aftercare steps following CABG:

• The patient will be moved to the ICU (intensive care unit) for monitoring immediately after the surgery. The patient could be kept on a ventilator for a couple of hours after surgery to help with breathing.
• Most patients stay in the hospital for about a week after the surgery. During this time, pain management, wound care, and gradual mobilization are important.
• Cardiac rehabilitation programs are recommended after the surgery, which involves supervised exercise, lifestyle counseling, and education on heart-healthy living.
• Regular follow-up visits with the cardiologist and cardiac surgeon are recommended to monitor recovery and manage any complications.

What are the risks of Coronary artery bypass grafting?

The following complications may be associated with CABG:

• Infection 
• Bleeding 
• Heart attack
• Stroke
• Arrhythmias 
• Kidney problems
• Cognitive problems
• Short-term memory loss

We hope that we were able to answer all your questions about CABG through this article.

If you want more information about CABG, you can contact a good cardiac surgeon at best hospitals like Manipal Hospital Whitefield. 

We only aim to give you information through the article and do not recommend any medication or treatment in any way. Only a qualified doctor can give you good advice because no one else is better than them.