CORONARY ARTERY BYPASS GRAFT (CABG)
A Heart bypass surgery is to creates a new route, known as a bypass, for oxygen and blood to go around a blockage to reach the heart muscles.
This surgery can take 4 to 6 hours. After the surgery, patient is taken to the intensive care unit(ICU).
Once the patient is under anesthesia, the heart surgeon will make an 8 to 10-inch surgical incision in the middle of patient’s chest. Patient’s breastbone is separated to create an opening. This permits patient’s surgeon to see patient’s heart and aorta, the major blood vessel leading from the heart to the rest of patient’s body.
Most patients who undergo coronary artery bypass surgery are put on heart-lung bypass machine or bypass pump.
• Patient’s heart is stopped while the patient is connected to this machine.
• The heart lung machine does the work of patient’s heart and lungs whilst patient’s heart is stopped for the surgery.
Another kind of bypass surgery which does not use the heart-lung machine and is done while the patient’s heart is still beating is known as off-pump coronary artery bypass, or OPCAB.
To create the bypass graft:
• The surgeon may take a vein or artery from other part of patient’s body and use it to make a detour (or graft) around the blocked area in patient’s artery. Patient’s surgeon can also use a vein known as the saphenous vein, from patient’s leg.
• A blood vessel in patient’s chest, known as the inside mammary artery (IMA), can also be used as the graft.
• Other arteries can additionally be used for grafts in bypass surgery. The most common one is the radial artery in patient’s wrist.
After the graft has been created, patient’s breastbone will be closed with wires. These wires stay inside the patient. The surgical incision is then shut with stitches.
Need for Heart Bypass surgery
Patient might need this surgery if he has a blockage in one or more of his coronary arteries. Coronary arteries are the vessels that supply patient’s heart with oxygen and nutrients.
When one or more of the coronary arteries develops partly or complete blockage, patient’s heart muscles does no longer get adequate blood. This is also known as ischemic heart disease, or coronary artery Disease (CAD). It can develop chest pains (angina).
Coronary artery bypass surgery can be used to improve blood flow to patient’s heart.
coronary artery Disease (CAD) is distinct from patient to patient. The way it is diagnosed and handled also varies. Heart bypass surgery is one such surgical treatment.
After the Heart bypass surgery
After the surgery, Patient will spend three to seven days in the hospital. Patient generally spends the first day in an intensive care unit (ICU). Patient then is moved to the ward or transitional care room for further recovery.
Risks associated with any surgery include:
Risks associated with Coronary bypass include:
• Infection, which include chest wound infection, the occurrence of such is high in obese, diabetic or such patients who have already undergone a surgery before.
• Heart attack
• Heart rhythm problems
• Kidney failure
• Lung failure
• Depression and mood swings
• Low fever, tiredness, and chest pain, together known as postpericardiotomy syndrome, which can last up to 6 months
• Memory loss, loss of mental clarity, or "fuzzy thinking"
Recovery from coronary bypass surgery takes time. Patient may not see the full advantages of surgery for three to six months. In most people who have heart pass by surgery, the grafts remain open and work well for many years.
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