Coronary Artery Bypass Surgery (CABG)

What is a bypass operation:

Coronary artery bypass surgery (also called coronary artery bypass grafting or CABG) is a treatment for patients with a blockage in the heart arteries. Coronary artery disease is narrowing or blockage of one or more of the coronary arteries that supply oxygen-rich blood to the heart. Most commonly, a bypass operation is performed when multiple heart arteries show very critical blockage.

Coronary artery bypass surgery restores normal blood flow to the heart by creating an alternate route(bypass) around the blocked artery/arteries. This is done by using a healthy blood vessel, called a graft. Grafts usually come from your own arteries and veins located in the chest, leg or arm. The graft creates a new pathway to carry oxygen-rich blood to the heart.

Why a bypass operation is done:

A bypass operation is done mainly to improve or preserve your heart function, usually called the ejection fraction. It mainly helps:

  • To relieve your symptoms of angina( Chest pain), difficulty in breathing, Palpitations or Ghabrahat or chest discomfort.
  • To improve your quality of life, so that you can live a healthy life and can resume your normal activities.
  • To increase your lifespan (it's now proven that bypass operation patients live much longer than patients who are taking only tablets).
  • Most importantly, to prevent death from a future heart attack.
What are the types of Bypass operation:

Off-Pump CABG or BEATING HEART BYPASS: In this technique, the heart keeps beating, while the surgeon stabilises the heart with a device called stabiliser and then performs the bypass grafts. This technique is physiological and in selected cases reduce many complications.

On Pump CABG – In this technique, you will be connected to a machine called the “heart-lung machine” and your heart will be stopped and then the surgeon performs the bypass grafts.

Day Of Surgery:

You will be wheeled into the cardiac operating room recovery area where the surgical and anaesthesia team will perform a final checklist of all the protocols and then you will be taken inside the operation room. Inside the operation theatre, the anaesthesia doctor may place a small needle with a catheter in your backbone area, also called a Thoracic Epidural catheter. This catheter will make your entire stay completely pain free. Following this, you will be put into a deep sleep and then the main operation would begin.

Teams of surgeons:

Usually, two teams work at the same time – one team usually works on the leg part and the other team works on the chest part. Usually, the best bone will be divided in the midline to access the heart but nowadays, a good number of bypass operations are done without opening the breast bone and this procedure is called “keyhole” or MIDCAB operation.

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