Insights on Coronary Artery Bypass Surgery or CABG Surgery

Coronary artery bypass graft, Coronary Artery Bypass Grafts, sometimes known as heart bypass surgery is a surgical procedure that helps the heart restore blood by bypassing blocked or narrowed coronary arteries. This is a life-saving surgery and is commonly performed for treating coronary artery disease, which may lead to heart attacks or heart failure. In CABG, a healthy blood vessel from another body part is connected to the blood vessels above or below the blocked artery. An artery transports blood from and to the heart muscles itself.

CABG surgery is needed when the arteries that supply blood to the heart, called coronary arteries, are narrowed or blocked. Coronary artery bypass surgery creates a new route for blood to flow that bypasses the narrowed coronary arteries. Traditionally open-heart surgery is still the most common surgery. Many new and less invasive procedures have been developed for bypassing blocked coronary arteries.

How are Coronary Artery Bypass Grafts from Other Cardiac Surgeries?

CABG Surgery in several ways differs from other cardiac surgeries such as where CABG is used to treat coronary artery disease, other cardiac surgeries might be used for treating different conditions such as heart valve problems and congenital heart defects. In the Coronary artery bypass surgery procedure, a healthy blood vessel from another body part is used to bypass narrowed coronary arteries and it can be performed either as open-heart surgery or less invasive off-pump surgery. Many other cardiac surgeries like angioplasty have not been that successful compared to CABG surgery. CABG might carry various risks like infection, bleeding, or in some cases heart attack but it reduces the symptoms such as shortness of breath, and chest pain, or improves quality of life. Hence, CABG might not cure prime heart disease, but it can still provide better benefits for patients with CAD (coronary artery disease) in comparison to other cardiac surgeries.

Various Types of Grafts Used in Coronary Artery Bypass Grafts

Some of the main types of grafts used in Coronary Artery Bypass Graftings are:

Saphenous Vein Grafts

The earliest grafts used for CABG surgeries are still the most used in coronary bypass surgeries. Saphenous vein ducts are collected from the legs and are grafted from the ascending aorta to the coronary artery beyond the unconstructive lesion.

Internal Thoracic Artery Grafts

The mammary or left internal thoracic artery grafts grow as the preferred bypass graft because of their excellent graft patency and closer to the left anterior descending artery (LAD).

Gastroepiploic Artery Grafts

These grafts are used by the extended sternotomy, dissected from the greater curvature of the stomach, and attached to the targeted vessel. It is considered one of the most difficult and rare surgeries.

Radial Artery Grafts

These grafts are used after gathering from the forearm.

Types of Coronary Artery Bypass Surgery Graftings

Two main types of Coronary Artery Bypass Graftings (CABG) surgeries are:

On-pump CABG

On-pump CABG is a more invasive surgery and requires the surgeon to open the chest bone or sternum, stop the heart, and place the patient on a heart-lung machine. This machine circulates oxygenated blood while the bypass is being performed.

Off-pump CABG

It is a minimally invasive surgery where the surgeon operates on the beating heart which reduces the risk of bleeding and stroke and this procedure does not require a heart-lung machine.

Endoscopic Vein Harvesting

This procedure harvests the greater saphenous vein (GSV), the most widely used conduit in coronary artery bypass surgery. Small incisions use an endoscopic camera, such as a blunt dissector, to create a subcutaneous tissue tunnel underneath the skin. The saphenous or greater saphenous vein is the longest in the human body and emerges from the dorsal foot veins. The main indication for endoscopic vein harvesting is coronary artery bypass surgery as a duct. Other vessels that might be bypassed include the internal mammary artery and the radial arteries. Endoscopic Vein Harvesting offers several benefits less pain, fast recovery time, Improved cosmetic results, and reduced risk of vein damage. It is one of the popular techniques for harvesting veins as it allows a more minimally invasive approach with better patient outcomes.

What are the symptoms of Coronary Artery Bypass Graftings: Risks and Complications

CABG Surgery is usually done to treat a blockage in artery narrowing coronary arteries. It restores the blood supply when non-surgical procedures are not in choice. Symptoms of CABG surgery include:

• Chest pain
• Fatigue
• Palpitations
• Abnormal heart rhythms
• Swelling in the hands or feet
• Indigestion
• Shortness of breath

The symptoms might not be visible in early coronary artery problems which can cause further risks and complications. Possible risks and complications of coronary artery bypass graftings include:

• Irregular heartbeat or Arrhythmias
• Infection occurring in chest, arm, or leg wounds
• Reduced kidney functions or kidney problems
• Heart attacks
• Brain-related problems like stroke, difficulty concentrating, or memory loss
• Bleeding or blood clotting

Patients Criteria for Coronary Artery Bypass Surgery

The surgery is recommended only when there are high-grade blockages in any of the major arteries. The criteria for CABG Surgery may include:

• Left main disease greater than 50%.
• Two-vessel disease: LAD plus on another major artery.
• Three-vessel coronary artery disease of greater than 70% with or without proximal LAD involvement.
• One vessel disease is greater than 70% in a survivor of sudden cardiac death.
• One or more significant stenosis greater than 70% in a patient with significant anginal symptoms.

Recovery

Here are some minor details on recovering after CABG Surgery, like Hospital stay in the intensive care unit (ICU) for the first few days for close monitoring. The hospital stay may depend on the patient’s progress and close monitoring. It is necessary to take plenty of rest and avoid many physical activities. Keep the incision clean and dry for the first few weeks to prevent infection, and listen to the doctor’s instructions after surgery. You might feel pain or comfort around the common wound, and the doctor might prescribe pain medication. Start light exercising and activities like short walks and attend all the follow-up appointments with your doctor to monitor the recovery process. Contact your doctor for signs of complications such as infection, swelling, discharge at the incision site, chest pain, or irregular heartbeats.

Best Hospitals and Surgeons for Coronary Artery Bypass Graftings

India has the best hospitals, excellent medical facilities, and technological advancements. Some of the best hospitals for Coronary Artery Bypass Surgery are:

• Fortis Hospital, Delhi, provides advanced technology in Cardiac Bypass Surgery in India, Interventional Cardiology, and non-invasive Cardiology. It has more than 250 cardiac surgeons, 5 Cath labs, and a dedicated cardiac ICU, along with echocardiography, stress tests, etc.
• Medanta Hospital Gurugram is one the best cardiac hospitals in India with specialties in Cardiac Surgery, Pacing, and Interventional Cardiology. It has the best 30 teams of cardiac surgeons and cardiologists, and Medanta has around 9 dedicated cardiac operation theatres and aftercare at affordable cost.
• Artemis Hospital, Gurugram, hasone of the most robust and cutting-edge technologies with the best medical expertise. They provide many services such as Non-invasive Cardiology, Paediatric Cardiology, and many more, and are equipped with dedicated Cardiac Ots and Cardiac Cath labs.
• Apollo Heart Institutes at Indraprastha is another one of the best hospitals in India that performs all kinds of Cardiothoracic and Cardiology procedures. It has advanced infrastructure that supports the complex nature of cardiac care. Apollo’s multi-skilled team of cardiac surgeons, cardiologists, and staff is behind the success of every surgery.
• Max Hospital, New Delhi, stands as the ray of hope in healthcare, especially in providing the best cardiovascular care. The surgeons here have experience performing complex cardiac procedures such as angioplasties, CABG surgeries, and heart valve replacements.

Indian surgeons perform surgeries with exceptional and intense care and have years of experience in their respective fields. Some of the top cardiac surgeons in India are:

• Dr. Z.S. Meharwal, one of the finest heart surgeons with an experience of over 42 years is currently working in Fortis Hospital. He has done over 20,400 and some complicated surgeries.
• Dr. Ajay Kaul, Fortis Hospital, has performed around 1500 operations till now. He has an experience of over 35 years in the respective field.
• Dr. Naresh Trehan, Medanta Hospital, has an in-hand experience of over 50 years and has done several complicated surgeries. He has been awarded the Padma Shree award and the Padma Bhushan award presented by the government of India.
• Dr. S.K. Sinha, Max Hospital, has 35 years of experience in cardiac surgical procedures and has varied experience in around 9,000 cases, all of which are of various complexity.
• Dr. Ramji Mehrotra, BLK Max Hospital, has a specialty in cardiothoracic surgery with in-field experience of more than 35 years. he has experience in heart surgical operations and many other successful techniques.

Conclusion

Coronary Artery Bypass Grafting is considered the most commonly used surgical procedure that restores blood flow to the heart and is regarded as a life-saving treatment for patients with severe coronary artery disease. It offers improved survival rates, reduced symptoms, and enhanced quality of life. While coronary Artery Bypass Surgery has some risks and complications, many new advancements in surgical techniques, grafting materials, and precise care have significantly improved and enhanced outcomes.

India is emerging as a center for coronary artery bypass surgery, with renowned hospitals and experienced cardiac surgeons offering affordable care. It has revolutionized the treatment by providing world-class care at affordable prices. This surgery in India has transformed countless individuals' lives, allowing them to return to their everyday lives. With such comprehensive healthcare facilities, India continues to provide accessible care for patients seeking CABG surgery. Medheal Global Care is devoted to providing state-of-the-art healthcare services by connecting patients with hospitals equipped with world-class medical facilities and renowned healthcare specialists. We help you with consultations, post-surgery care, 24/7 support, and local transportation.