Coronary Artery Bypass(Heart Bypass) Surgery in India

Coronary Artery Bypass Graft Surgery (CABG) is a surgical method performed to improve the flow of blood & oxygen to the heart muscle. The narrowing of the coronary arteries hinders the blood flow through the blood vessels of the heart and can cause a heart attack. The major reason behind the blockage of arteries is the accumulation of fatty substances and cholesterol over a period of time. The surgery helps in re-routing blood to the heart muscles, relieving chest pain and improves function of the heart muscles.

Who Should Consider Coronary Artery Bypass Graft Surgery?

  • People diagnosed with arterial blockage or heart damage are recommended with the Coronary Artery Bypass Graft Surgery.
  • People suffering from severe chest pain or angina due to the arterial blockage are recommended with the Coronary Artery Bypass Graft Surgery.
  • People suffering from complicated conditions such as diabetes & high blood pressure are recommended the Coronary Artery Bypass Graft Surgery to reduce the risk of heart attack.

What to Expect After Coronary Artery Bypass Graft Surgery ?

Post surgery, you will be kept in the intensive care unit (ICU) for a short period of time (1 to 2 days). In the ICU, you will undergo following things:

  • Perpetual scrutinizing of the functioning of the heart muscles
  • A temporary tube will be attached to help you with breathing
  • A thin plastic tube is inserted into the neck vein and roped down into the heart & the pulmonary artery to check the flow of blood & oxygen in the heart.
  • A tube is inserted to remove stomach emanation until you return to a normal diet
  • A catheter is inserted to drain the bladder and measure urine output
  • A tube is attached to the veins in the arms through which liquid, nutrition and medication is given
  • A catheter is directly placed into the artery to measure blood pressure
  • A tube is inserted into the chest to drain the fluid & blood

Benefits of Coronary Artery Bypass Graft Surgery

Some of the potential benefits of Coronary Bypass Heart Surgery (CABG) include :

  • Lower risk of stroke
  • Lower death rate
  • Less need for transfusion
  • Less heart rhythm problems
  • Less injury to the heart

Procedure for Coronary Bypass Surgery

During a Coronary Artery Bypass Graft Surgery (CABG), the blood flow is re-routed around the clogged artery by detaching a long segment of an artery from the chest wall, arms or leg veins. Thereafter, the new artery is grafted to the clogged area of the coronary artery. Through the newly attached channel, blood gets unhindered route to flow to the heart muscles. This procedure is known as Coronary Artery Bypass Surgery. Depending upon the number of blocked coronary arteries, a patient may undergo more than one bypass graft.

How long does Coronary Bypass Surgery take ?

A Coronary Artery Bypass Graft Surgery (CABG) procedure generally takes 3 to 5 hours but it can vary depending upon the number of arteries that needs to be bypassed.

Post Operative Care for Coronary Artery Bypass Surgery

Post the surgical procedure, you’ll spend 1 or 2 days in the Intensive Care Unit (ICU). Here, your blood pressure, heart rate, oxygen levels is regularly checked throughout the recuperation period. Thereafter, you will be transferred to a traditional hospital room, where you’ll stay for next 4 to 5 days before being discharged. The recuperation may last anywhere between 6 to 12 weeks following the CABG surgery including home care & regular follow-ups with the doctor.

FAQs for Coronary Artery Bypass Grafting or Heart Bypass Surgery

There are 3 types of CABG surgery namely:

  • Traditional CABG
  • Off-Pump CABG
  • Minimally Invasive CABG.

The CABG surgeries differ from each other in various manners. Take a look:

Traditional CABG – This is a very common procedure and during the surgery, the incision is made through the breastbone and a heart-lung bypass machine is used. During this procedure, the heart is stopped and a heart-lung machine is used to pump blood and perform the functions normally achieved by the lungs.

Off-pump CABG – In this procedure, the surgeons take an artery or a vein from another place in the body, then use the vessel to bypass the blocked part of the vessel and restore normal blood flow to the heart. In Off-pump CABG, the heart is not stopped and the heart-lung bypass machine did not use.

Minimally invasive CABG – During the surgery, the surgeon makes small incisions on the right side of the chest to reach the heart between the ribs. This is an advanced technique and instead of cutting large incisions through the breastbone, several small incisions are made. Minimally invasive heart surgery can be performed to treat a variety of heart conditions.

As this procedure performs with advanced technologies, still there are some risk factors involved. After surgery, the possible complication includes bleeding, blood clots, irregular heartbeat, chest pain, infection in the wound, stroke, kidney problems, and memory problems. All these risks can be reduced by following the doctor’s instructions after surgery.

After anesthesia, the surgeon takes an extra blood vessel from another part of the body because the body has many other ways of getting blood to areas and it is safe to do as well. The surgeon then attaches both ends of the graft. During operation, the body connects with a heart-lung bypass machine which keeps the blood and oxygen flowing when the heart function is stopped at the time of operation.

Yes, this procedure has been performed on patients for more than 50 years. These surgeries are serious but safe as well. The patient who has undergone this surgery gets relief from their problems without needing long-term medication.

Any kind of risk or complicated becomes high due to the following:

  • Age (older than 70 years)
  • Chronic lung disease
  • Disease obstructing the left main coronary artery
  • Diabetes
  • Chronic kidney failure
  • Poor heart muscle function

After CABG surgery, the patient needs to stay in the hospital for approximately 6 nights, which includes 1 night in ICU and 1 night in HDU and the rest of the nights in a normal ward. Many patients start sitting on a chair the next day and start walking after 3 days of surgery and using stairs after 6 days. As it is a serious procedure, it is very normal for the patient to feel uncomfortable and tired. The prescribed medication helps the patient to reduce these.

In starting, the patient should indulge in walking and light exercise as suggested by the physiotherapist in the hospital. After 2 weeks, the patient can slowly increase activity level and walking is very good at this time as well. The patient should always consult with doctors regarding the exercises and activities in which they should indulge or not. Sometimes, wound infections can occur in 9-10 days after surgery. If the patient experiences a wound and it becomes very painful or looks red, inflamed or swollen then contact with the doctor.

Doctors always recommend patients to attend cardiac rehabilitation sessions which help in getting full benefits of surgery.

There are many important investigations required before CABG surgery – blood test, ECG, EKG, Echocardiogram, chest X-ray, cardiac catheterization, and angiography. If any patient has a history of diabetes, high blood pressure, and high cholesterol, then the doctor deals with them first and then proceeds for CABG surgery.

It will take approximately 6 to 12 weeks to recover from surgery. The patient should follow instructions given by the doctor for post-surgery care, which will help in healing and speedy recovery.

 The symptoms for CABG depend on various factors such as Left main artery disease, Failed PTCA, narrowing of three coronary arteries, blockage of grafts from previous CABG, and Myocardial Infarction.

After surgery, most people feel better and remain symptom-free for approximately 10 to 15 years. Over time, there is a possibility of other arteries or new graft used in bypass surgery that will get blocked which requires another bypass or angioplasty. The results and longevity will depend on various factors such as proper medication, lower cholesterol and blood pressure, diabetes should be controlled, stop smoking, follow a healthy diet plan, maintain a healthy weight, regular exercise, and proper stress management.

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