Coronary Artery Bypass Graft (CABG) is one of the most commonly performed major operations. Coronary Artery Bypass Graft is a type of surgery that improves the flow of blood to the heart. Coronary Artery Bypass Graft is utilized by surgeons to treat individuals with severe coronary heart disease (CHD). Coronary heart disease is a disease in which a waxy substance known as a plaque (plak) accumulates in the coronary arteries. The function of the arteries is to supply the heart with oxygenated blood.
Why do I need coronary artery bypass surgery?
This surgical procedure is used by physicians to treat blockage or narrowing of one or more coronary arteries in order to restore the supply of blood back to the heart muscle.
Symptoms of coronary artery disease
Below are the symptoms of coronary artery disease:
- Pains on the chest
- Fatigue (severe tiredness)
- Abnormal heart rhythms
- Shortness of breath
- Swelling of hands and feet
- Digestive disorders
How to prepare for coronary bypass surgery?
When preparing for coronary bypass surgery information will be disseminated to you by your doctor on restrictions from specific activities and dietary changes or medications you need to take before the operation. Some tests such as chest x-rays, blood tests, electrocardiograms and coronary angiogram are required before the surgery. Coronary angiography is a special type of X-ray procedure that makes use of dye to visualize the arteries that feed your heart with blood.
Most people were hospitalized in the morning prior to the surgery. Coronary bypass surgery can also be performed in emergencies, for example after a heart attack.
Make sure you make arrangements for weeks after the surgery. It will take about four to six weeks to recover to the point where you can resume back to activities such as driving, go back to work, and perform daily tasks.
What you can expect during the coronary bypass procedure
It takes 3-6 hours to complete the surgery and general anesthesia is required. The amount of bypass needed depends on the position and how severe the blockage in your heart.
Majority of coronary bypass surgeries are performed via a long incision in the chest, while the flow of blood is measured by a heart-lung machine. The machine is known as on-pump coronary bypass surgery.
During this procedure, the surgeon makes a cut down the center of the chest, along with the sternum. The surgeon then opens the ribs wide in order to show the heart. After opening the chest, the heart is temporarily stopped and the heart-lung machine takes over the blood circulation in the body.
The surgeon takes a healthy blood vessel section, often from the inner part of the chest wall (the internal mammary artery), it can also be taken from the lower leg and fastens the extremities above and below the blocked artery so that the blood flow is diverted (bypassed) around the narrowed part of the affected artery.
There are other surgical techniques that your surgeon can use in case you are undergoing bypass surgery:
1. Off-pump or beating-heart surgery. This procedure allows the surgical operation of the still-beating heart with special equipment to stabilize the heart area where the surgeon is working. This type of surgery is difficult because the heart is still moving. For this reason, that is not an option for everyone.
2. Minimally invasive surgery. A coronary bypass is performed during this procedure by the surgeon via a smaller incision in the chest, often using robotics and video imaging to assist the operation of the surgeon in a small area. Variations in the minimally invasive surgery can be referred to as port-access or keyhole surgery.
After general anesthesia has begun, a breathing tube is inserted via the mouth and the tube is attached to the ventilator, which assists you to breathe during and immediately after the operation.
After the coronary bypass procedure
Coronary bypass surgery is the major operation. It is expected of you to spend a day or two in the intensive care unit after the coronary bypass surgery. Here you will constantly monitor your heart, blood pressure, breathing and other vital signs.
Your breathing tube will remain in your throat until you are awake and able to breathe independently without the use of a ventilator.
If you do not have a complication, you will probably be released out of the hospital within a week, but even after you are been discharged, you may have trouble doing daily tasks or even walking a short distance. If you experience any of the following signs or symptoms after returning home, call your doctor. It could be a warning that the chest wound has been infected:
- Fast heart rate
- New or worsened pain around your chest wound
- Reddening around your chest wound or bleeding or other discharge from your chest wound
The expected recovery period is between 6 to 12 weeks. In most cases, you can go back to work, start practicing and continue sexual activity after 4-6 weeks, but before doing so, make sure your doctor permits you to do such.
Coronary bypass Results
After surgery, most people feel better and can remain symptom-free for 10 to 15 years. After some time, be that as it may, it is likely that other arteries or even the new graft used in the bypass will become clogged, requiring further bypass or angioplasty.
Although the bypass surgery improves blood flow to the heart, it does not treat the underlying heart attack. The results you get and long-term outcome will depend to a limited extent on taking drugs to prevent blood clots, reduce blood pressure, reduce cholesterol and assist you in controlling your diabetes as directed, and follow the following healthy lifestyle recommendations such as those ones listed below:
- Quit smoking.
- Follow a healthy diet plan, such as a DASH diet.
- Maintain a healthy weight.
- Regular exercise.
- Stress management.
In addition to changing the lifestyle, you will need after surgery; your doctor will often recommend a cardiac rehabilitation program. Cardiac Rehabilitation - also known as Cardiac Rehab - is a personalized program of exercise and education which is designed to assist you in recovering from heart attacks, other forms of heart disease, or after surgical operations to treat heart disease. Cardiac rehabilitation often begins while you are still in the hospital and continues with outpatient programs as long as home care programs cannot be safely followed.