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Coronary Artery Bypass Surgery

Coronary artery bypass surgery, often called CABG (pronounced 'cabbage'), creates a new route for blood to flow around a blocked or narrowed coronary artery. This procedure involves using a healthy blood vessel, often taken from the chest, arm, or leg, to bypass the blockage. The new blood flow restores oxygen supply to the heart muscle, reducing symptoms such as chest pain and improving overall heart function.

Alternative Names for the Surgery Include

Coronary artery bypass grafting
CABG
Heart bypass surgery
Coronary artery bypass graft surgery

While the surgery doesn't cure the underlying heart condition like atherosclerosis or coronary artery disease, it alleviates symptoms and reduces the risk of life-threatening complications such as heart attacks.

Why is it Performed

This surgery is recommended for restoring blood flow when one or more coronary arteries are severely blocked or narrowed.

Your healthcare provider may suggest coronary artery bypass surgery if:

There is a blockage in the left main coronary artery, which supplies most of the heart's blood.

A blockage can't be managed with less invasive treatments like angioplasty or stenting, or if previous procedures have failed.

You experience severe chest pain due to narrowed arteries that limit blood flow even during rest.

An emergency bypass is needed during a heart attack when other treatments are ineffective.

Multiple heart arteries are diseased, and the heart's main pumping chamber (left ventricle) isn't functioning well.

Risks of Coronary Artery Bypass Surgery

As with any major surgery, there are risks involved. These may include:

  • Bleeding or infection at the surgical site
  • Arrhythmias (irregular heartbeats)
  • Blood clots, which can lead to a heart attack or stroke.
  • Kidney problems or temporary memory issues
  • Prolonged dependence on a breathing machine in rare cases

Preparation for Surgery

Before the surgery:

  • Follow instructions on dietary changes and medication adjustments.
  • Arrange for someone to assist you after discharge.
  • Undergo necessary heart and blood tests in the days leading up to surgery.

Certain factors, like diabetes, kidney disease, or chronic obstructive pulmonary disease (COPD), can increase the risk of complications.

What to Expect During the Procedure

Coronary artery bypass surgery typically lasts 3 to 6 hours and involves the following steps:

  • General Anesthesia is administered, ensuring you're in a sleep-like state.

  • A breathing tube is inserted and connected to a ventilator.

  • If on-pump surgery is performed, a heart-lung machine takes over the heart's functions while the heart is temporarily stopped.

  • A section of a healthy blood vessel, called a graft, is attached to bypass the blockage.

Some advanced approaches include:

  • Off-pump or beating-heart surgery, which doesn't use a heart-lung machine.

  • Minimally invasive bypass surgery, performed through small incisions instead of opening the chest.

After the Surgery

Post-surgery care involves close monitoring and gradually resuming activities:

  • A breathing tube remains until you can breathe on your own.
  • Expect a hospital stay of about 5 to 7 days, with initial recovery in an ICU.
  • Cardiac rehabilitation begins early to improve heart health and prevent future issues.

Contact your healthcare provider if you notice:

  • Fever or rapid heart rate.
  • New or worsening chest pain.
  • Discharge, redness, or swelling near the surgical site.

Recovery typically takes 6 to 12 weeks. You can return to daily activities, including driving, work, or exercise, as advised by your doctor.

Results and Long-Term Care

Most people experience significant relief from symptoms and improved quality of life after coronary artery bypass surgery. However, grafts or arteries may narrow again over time.

To maintain your heart health:

  • Quit smoking and avoid second-hand smoke.
  • Follow a heart-healthy diet rich in fruits, vegetables, and whole grains.
  • Exercise regularly under medical guidance.
  • Manage stress and consider mindfulness or support groups.
  • Control conditions like diabetes, high blood pressure, and high cholesterol.
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