Coronary artery bypass grafting (CABG) is an open-heart surgery that is performed to bypass a blockage in an artery and restore blood supply to the heart. Improper blood and oxygen supply to the heart can cause exhaustion and can result in heart failure. It can be a single, double, triple, or quadruple bypass graft surgery depending upon the number of arteries requiring bypass. CABG surgery is recommended when other forms of treatments such as medicines or angioplasty have failed to adequately resolve the plaque. This surgery helps in reducing the risk of stroke and heart failure and can increase the life of a patient by many years.
Alternate Name of CABG Surgery
Heart bypass surgery
Chest (heart) and arm/leg from where the artery to be used as a graft for the bypass is harvested.
How CABG Surgery is Performed?
For the CABG procedure, you will be given general anesthesia through IV and put to a painless, deep sleep.
Your cardiovascular surgeon will then make an incision in the middle of your chest and spread open your rib cage to access the heart.
The surgeon will then make an incision in your arm or leg, from where a healthy blood vessel will be harvested to be used as a graft. One end of this blood vessel will be sutured above the blocked area of the diseased vessel of the heart and another end below the plaque, in such a way that a bypass route is created for the blood to flow through the artery and to the heart.
The blood flow through the bypass will be checked, the pumping of your heart will be resumed, and you will then be sutured back, bandaged, and transferred to ICU for further care and monitoring.
Preparation for CABG Surgery
You will have some pre-procedure appointments, during which your doctor will ask you about your family medical history, and if you are suffering from any other diseases. You should tell your doctor about all the medications that you are currently taking, including any vitamins, herbs, or supplements. You might be asked to stop certain medications that might interfere with blood clotting at least 48 hours before Cabg surgery.
You will need to undergo some blood tests, X-rays, and ECG (electrocardiogram) to assess your general health. Angiography might also be performed preoperatively to have a clear picture of the status of blood flow in the arteries.
Stop smoking, as it prolongs the healing time.
You will need to fast, including not consuming water, from midnight before the CABG surgery.
Take all the medications that your surgeon has asked you to take before the CABG surgery.
Be prepared to stay in the hospital for several days and make all the necessary arrangements.
Procedure Type of CABG Surgery
Follow-Up After CABG Surgery
Follow-up care is very important after heart bypass surgery to reduce the risks of postoperative stroke, heart failure, or even death. Close monitoring by your physician is crucial to ensure that the healing and recovery are taking place at a normal pace and that no post-surgical complications are developing.
You must inform your physician if you are developing any signs of wound infections, such as fever, pain around the incision, pus or drainage from the wound, etc.
Participating in a cardiac rehabilitation program after the bypass surgery is very beneficial for faster recovery and restoration of normal heart functioning and your ability to perform activities of daily living. It is a comprehensive program that includes exercise, relaxation, and education. It starts 2 to 6 weeks after discharge from the hospital and lasts for about 6 weeks.
Risks Factor of CABG Surgery
Like all other surgical procedures, heart bypass surgery is also associated with certain risks. Factors such as age, general health condition, comorbidities, and a number of bypasses are required to affect the risk profile. Listed below are the common risks:
- Blood clots may lead to heart attack or stroke.
- Adverse reaction to anesthesia
- Irregular heart rhythm (arrhythmia)
- Chest pain
- Difficulty breathing
- Infection at the incision site
- Kidney problems
Recovery after CABG Surgery
If you do not suffer from any complications, recovery from coronary artery bypass grafting takes at least 6 to 12 weeks.
When you wake up from CABG surgery, you will most likely be experiencing pain around the incision sites, pain while breathing, and coughing. You might have difficulty sleeping. Your doctors will give you medications to relieve these symptoms, and you will feel better each day. You will stay in the ICU for 1 or 2 days to monitor your vital signs and symptoms, following which you will be shifted to a hospital room.
Walking will be initiated within 1-2 days of CABG surgery. Avoid lifting heavy weights for several weeks. You should be able to resume light duty about 6 weeks post-surgery and will regain full strength in about 3 months. Resuming driving can take up to 4 to 6 weeks.