Coronary Artery Bypass Graft (CABG) Surgery

Essential Facts About CABG Surgery You Should Know

Coronary Artery Bypass Graft (CABG) surgery is critical for patients with considerable coronary artery disease (CAD), as plaque clogs the arteries and reduces the blood flow to the heart. CABG is performed by grafting one blood vessel over the clogged artery and restoring normal blood flow.

However, while CABG can significantly improve symptoms and quality of life, it's essential to understand the causes leading to the surgery, potential risks, and the recovery process. Keep reading to learn more about the before and after of CABG surgery.

What Leads to CABG Surgery?

The main factors that necessitate CABG surgery are:

• Coronary Artery Disease (CAD): The most common cause of CABG. A buildup of fatty deposits (plaques) in the coronary arteries leads to atherosclerosis and reduced blood flow to the heart.
• High Cholesterol: Excessive low-density lipoprotein (LDL) cholesterol helps build up plaques, which can block your arteries, increasing your chances of heart disease.
• Hypertension (High Blood Pressure): High blood pressure eventually damages the arteries, increasing the chance of blockages.
• Diabetes: People with diabetes are more likely to develop coronary artery disease because of extra plaque in their arteries.
• Previous Heart Attack: When someone has a history of heart attacks due to coronary disease, CABG is performed to improve blood flow.
• Failure of Other Treatments: If medicines or treatment such as angioplasty and stenting fail, experts may recommend CABG.

What are the Symptoms Indicating the Need for CABG?

Individuals may experience:

• Chest pain (angina)
• Shortness of breath
• Fatigue
• Irregular heartbeats
• Swelling in the legs, ankles, or feet.
• Excessive sweating
• Dizziness or Lightheadedness

What is the Diagnosis Before CABG?

To determine the need for CABG, doctors may perform:

• Electrocardiogram (ECG): Monitors the electrical signalling of the heart.
• Echocardiogram: Detects the function of the heart using ultrasound.
• Stress Tests: Assess heart performance under physical exertion.
• Cardiac Catheterisation (Coronary Angiogram): A dye injection allows specialists to view the blockages and decide if CABG is necessary.
• Pulmonary Function Test (PFT): This test checks the patient's lung function to determine whether surgery is safe.
• Carotid Doppler Ultrasound: Helps find blockages in the carotid arteries that may lead to a higher risk of stroke during surgery.
• Ankle-Brachial Index (ABI): Leg circulation is examined to identify peripheral artery disease.

What is  The CABG Procedure?

CABG surgery restores blood flow by rerouting circulation past blocked arteries. Here’s an overview of the surgical process:

1. Preparation: The patient is placed under general anaesthesia, and the chest is sterilised for surgery.
2. Incision: A median sternotomy(opening the chest) is performed to access the heart.
3. Harvesting Grafts: Blood vessels are taken from other parts of the body, such as the saphenous vein (leg), radial artery (arm), or internal mammary artery (chest).
4. Cardiopulmonary Bypass: A heart-lung machine may temporarily take over heart function during surgery.
5. Graft Placement: The harvested vessels are attached to the coronary arteries beyond the blockages, creating new pathways for blood flow.
6. Closure: The chest is closed, and the patient is monitored in intensive care for recovery.

The procedure typically lasts 3 to 6 hours and requires general anaesthesia.

What are the Risks and Complications of CABG Surgery?

CABG surgery carries certain risks and potential complications, as with any major surgical procedure. Some of the key risks include:

• Heart Attack or Stroke– There is a small chance of experiencing a heart attack (5%-10%) or stroke (1%-2%) during or after surgery.
• Bleeding– Some patients may require a second surgery due to excessive bleeding (about 5% of cases).
• Infection– Wounds in the chest, arm, or leg (where grafts are taken) can become infected, though most infections can be treated with antibiotics.
• Irregular Heartbeat (Arrhythmia)– Atrial fibrillation, an irregular and often fast heart rate, can occur but is usually manageable with medication.
• Kidney Issues– Some patients experience temporarily reduced kidney function, which may require dialysis in rare cases.
• Memory and Cognitive Issues– Some individuals report difficulty concentrating or memory problems after surgery, which may improve over time.
• Chest Pain– Some patients experience chest pain due to musculoskeletal issues, infections, or other factors.

Certain factors increase the risk of complications:

• Advanced age
• Previous heart surgeries
• Other health conditions, like diabetes or lung disease

What Helps Recovery After CABG Surgery?

Recovery involves several stages:

• Hospital Stay: Typically 5 to 7 days, including time in the intensive care unit.
• Initial Recovery: Focus on rest and gradually increase activity at home for the first few weeks.
• Full Recovery: May take 6 to 12 weeks, depending on individual health and adherence to rehabilitation.

Post-Surgery Care

• Medication Management: Continue prescribed medications, including antiplatelet drugs (aspirin, clopidogrel) to prevent clot formation and cholesterol-lowering statins to maintain artery health.
• Wound Care: Keep the surgical incision clean and dry to prevent infections. Watch for redness, swelling, or discharge.
• Gradual Physical Activity: Begin with gentle walking and slowly advance your activity as guided by your doctor.
• Dietary Changes: Follow a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins while avoiding saturated fats and processed foods.
• Blood Pressure & Diabetes Control: Maintain optimal blood pressure and blood sugar levels to prevent further artery damage.

Prevention Strategies

• Quit Smoking: Smoking significantly raises the risk of artery blockages and heart disease.
• Weight Management: Keep a healthy weight to ease the heart’s workload.
• Regular Check-Ups: Schedule routine follow-ups to monitor heart health and detect any early signs of complications.
• Stress Management: Relieve stress with relaxation methods such as meditation, yoga, or deep breathing.
• Limit Alcohol Intake: Excessive alcohol can raise blood pressure and cholesterol levels.

Health insurance plans, such as those offered by Star Health Insurance, can provide coverage for post-operative care, medications, and rehabilitation programs, ensuring comprehensive support during recovery.

CABG surgery is a vital procedure for individuals with severe coronary artery disease. Understanding the causes, risks, and recovery process is essential for optimal outcomes. With proper care and lifestyle modifications, patients can lead a healthier life post-surgery.

Also Read:

→ Difference Between Reconstructive and Cosmetic Surgery

→ Standard Surgical Procedures for a Dislocated Knee

→ What is ACL Surgery

→ What is Hernia Surgery

→ Which Artery is Used for Bypass Surgery