Coronary artery bypass Grafting In India

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Coronary Artery Bypass Grafting is the most common type of heart surgery. Coronary Artery Bypass Grafting (CABG) improves blood flow to the heart. Surgeons use CABG to treat people who have severe coronary heart disease (CHD). In this disease, the arteries which supplies the Blood & Oxygen to the heart muscle gets harden & waxy substance also known as Plax builds up. There are some of the Best Cardiologist in India that takes on this surgery. In CABG surgery, the surgeon takes out a healthy Artery (Vein) from the body, mainly from the Leg & one end is grafted to the clogged artery & the other side is attached to Aorta, so as to create a new way for oxygen-rich Blood is frequently flows to the Heart Muscle.

Who needs a Coronary Artery Bypass Grafting (Cabg) Surgery

Bypass is done for the following reasons:-

Plaque: which is a component of blood builds up in the artery and blocks the way. This reduces the blood flow in the heart so the heart muscle is more likely to tire or fail. This causes failure in the left ventricle which is known as the main pump of the heart.
Coronary artery disease or atherosclerosis – If the coronary arteries become narrow or constricts so there is an increased chance of fatal heart attack.
When the blockage is too grave to be managed by medication (beta blockers) or other alternative treatments (balloon angioplasty).
Severe CAD – This condition involves clogging of arteries by fatty deposition which reduces blood flow.

Why need Coronary Artery Bypass Grafting (Cabg) Surgery

Bypass surgery is performed to improve the blood flow of the heart which has been blocked by plaque (atherosclerosis) or blood clots. The surgery involves taking a piece of (artery or vein) from somewhere else in the body and creates an alternative route or a bypass through the blocked area of coronary artery.

Risks associated (Cabg) surgery

Bleeding
Wound infection: More common in obese and diabetic patients
Breathing problems
Injury to blood vessels and nerves
Formation of blood clots
Irregular heartbeat
Kidney failure
Heart attack or stroke
Death.

Before the (Cabg) surgery

Complete blood count (CBC): A low blood count can warn your doctor to prepare for a blood transfusion in advance.
Prothrombin time (PT) and thromboplastin time (PTT) values: These blood tests measure your blood’s bleeding and clotting time. These tests show altered values in presence of any bleeding or clotting disorders or if you’re on blood-thinning medications like aspirin.
Chest X-ray: To assess the size and shape of your heart and aorta.
Cardiac catheterization: This test is used to identify the location of blockages in your coronary arteries that will help your doctor in planning your surgery.
Other tests, such as kidney and liver function tests to determine the health of these organs.

Instructions Before Surgery

For about 1 week prior to the surgery you may be asked to stop taking drugs that reduces the chances of blood clothing for e.g. :ASPIRIN ,IBUPROFEN, NAPROXEN.
Patient should stop smoking.
Inform your doctor if you have fever, flu, herpes breakout or any other illness.
One day before the surgery: The patient is asked not to eat or drink anything after midnight the night before

Procedure of Coronary Artery Bypass Grafting Surgery.

During the Coronary Artery Bypass Grafting (CABG) surgery, the surgeon first makes a long vertical incision of 8-10 inches in the middle of the chest.
The surgeon then divides the breast bone so that the heart and aorta could be seen and reached easily.
After pulling the breast bone back the surgeon makes a vertical incision on the pericardium that covers the heart.
Throughout the surgery the patient is connected to a heart lung bypass machine or bypass pump.
This machine is a like a substitute during the surgery as it performs the function of the heart.
The machine is connected to the aorta and the right atrium through tubes. The machine also regulates according to the temperature of the heart.
When the heart has been stopped, the doctor will do the bypass graft procedure by sewing one end of a section of vein over a tiny opening made in the aorta, and the other end over a tiny opening made in the coronary artery just below the blockage.
The surgeon takes the blood vessels that are to be used as grafts from the patient’s legs or one of his/her wrists. After removing the vessel he will close the incision.
Remember, while performing a coronary artery bypass graft surgery, the heart is stopped, that is, it neither beats nor does any of its functions. But yes in some cases the surgery is performed while the heart is still beating.
The former procedure is known as on-pump Coronary Artery Bypass Grafting (CABG) surgery whereas the other one is known as off-pump CABG surgery.
In case of off pump CABG surgery the heart lung bypass machine is not required. In this an artery or a vein is taken from any other part of the body to make a detour or a graft around the blocked area. Grafts can be taken from saphenous vein from the leg, internal mammary artery (IMA), or most commonly radial artery.

What are the side effects of Cabg surgery?

Tiredness: This is quite common after a major operation. The body is busy doing the repairing process of the wound. Allow adequate rest for the body and mind. As the days progress, you will feel better.
Reduced Appetite: There are several reasons for loss of appetite. Distaste caused by some of the medications is a common problem. Acidity caused by stress and some medicines is another reason.
Pain: is the commonest problem. Remember there are safe pain killers which may be used regularly until pain in relieved fully. It is important to take regular pain medications in the first two weeks.
Sleeplessness: Anxiety and pain are the villains. In the first few weeks you require adequate pain relief. As the health improves, your normal sleep habit will return.
Swelling of legs: Mild or even moderate swelling of feet and legs are common after veins have been removed during CABG. This is not a disease. The deep vein system will take care of the blood circulation adequately. It takes some time for the body to make this adjustment. Simple methods like leg elevation and crepe bandages or elastic stocking can relieve this problem.
Sore throat: The plastic tube which is kept in the windpipe during anesthesia and immediate post operative period can cause mild inflammation and pain in throat during first few days. Mild pain killers and warm saline gargles can take care of this.
Numbness: One of the most common and consistent complaints after bypass operation is the pain and numbness in the left side of chest. Fine nerves along the Internal Mammary Artery (IMA) are cut while harvesting this artery for bypass. These are nerves that supply the front of chest. There may be numbness, burning pain, different feeling during touch or shooting pain. Usually Left IMA is taken. So the symptoms are on the left side of chest (may involve breast in women). If both IMA are used these symptoms can occur on both sides. The symptoms gradually resolve.

After the Cabg Surgery

Patient is hospitalized for another 3-7 days.
Tubes will be fitted around the heart to remove the fluid around the heart.
The patient will have a catheter and intravenous line attached to the body. Machine will be attached to the patient to monitor temperature, blood pressure and breathing.
It takes around 4 to 6 weeks for a complete recovery.