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Coronary Artery Bypass Graft Surgery

CABG full form in medical is Coronary artery bypass grafting, commonly referred to as heart bypass surgery, is a medical procedure used to treat coronary artery disease (CAD). CAD occurs when the blood vessels that supply oxygen and nutrients to the heart muscle become narrowed or blocked due to the buildup of plaque, a sticky substance made up of cholesterol and other cellular debris. This reduced blood flow to the heart can lead to chest pain (angina), shortness of breath, and in severe cases, heart attack.

CABG is a surgical technique designed to create a new pathway for blood to flow to the heart muscle, bypassing the blocked or narrowed arteries. During the procedure, a surgeon takes a healthy blood vessel, often from the leg (saphenous vein) or the chest (internal mammary artery), and attaches one end above the blocked area of the coronary artery and the other end below the blockage. This creates a new route for blood to reach the heart muscle, allowing it to receive an adequate supply of oxygen and nutrients.

Other names for this surgery are:

  • Coronary artery bypass grafting.

  • CABG — pronounced "cabbage."

  • Coronary artery bypass graft surgery.

  • Heart bypass surgery.

    Coronary artery bypass surgery doesn't cure the heart disease that caused a blockage, such as atherosclerosis or coronary artery disease. But it can reduce symptoms such as chest pain and shortness of breath. The surgery, commonly called CABG, may reduce the risk of heart disease-related death.

Coronary Artery Bypass Surgery Types

There are two main types of coronary artery bypass grafting (CABG) surgery:
  1. On-pump CABG - On-pump CABG is the most common type of CABG. It is a major surgery that is usually performed under general anesthesia. 
    During on-pump CABG, the surgeon will make a long incision in the middle of your chest and open the chest to expose the heart. Then, they will place you on a heart-lung machine. The heart-lung machine will take over the function of your heart and lungs while the surgeon performs the bypass surgery.

    To perform the bypass surgery, the surgeon will take a healthy blood vessel from another part of your body, such as your leg or arm. This blood vessel is called a graft. The surgeon will then attach the graft to the coronary artery above and below the blockage. This creates a new pathway for blood to flow to the heart muscle.

    Once the bypass surgery is complete, the surgeon will take you off the heart-lung machine and close the chest and incision.

  2. Off-pump CABG - Off-pump CABG is a newer type of CABG that does not require a heart-lung machine. Instead, the surgeon uses special devices to stabilize the heart while the graft is attached.

    Off-pump CABG is a more complex surgery than on-pump CABG, but it may offer some advantages, such as a reduced risk of bleeding and infection.

There are also several variations of CABG surgery, including:
  1.  Minimally invasive CABG - Minimally invasive CABG is a type of CABG that uses smaller incisions and less disruption of the chest wall. Minimally invasive CABG may be an option for some people, but it is not always possible.

  2. Robotic-assisted CABG - Robotic-assisted CABG is a type of minimally invasive CABG that uses a robotic system to assist the surgeon. The robotic system allows the surgeon to perform the surgery with greater precision and control. Robotic-assisted CABG may be an option for some people, but it is not available at all hospitals.

  3. Hybrid CABG - Hybrid CABG is a type of CABG that combines on-pump CABG with other procedures, such as angioplasty or stenting. Hybrid CABG may be an option for people who have complex coronary artery disease or who are at high risk for complications from on-pump CABG.

Coronary Artery Bypass Surgery Procedure

CABG surgery is usually done under general anesthesia, which means that you will be unconscious during the surgery. The surgery typically takes 3 to 6 hours, depending on how many coronary arteries need to be bypassed.

Here is a step-by-step overview of the CABG surgery procedure:

  • The surgeon will make a long incision down the center of your chest.

  • The surgeon will spread open your rib cage to expose your heart.

  • If you are having on-pump CABG, the surgeon will place you on a heart-lung bypass machine. This machine will take over the function of your heart and lungs while the surgery is being performed.

  • The surgeon will remove a section of healthy blood vessel from another part of your body. This is called the graft.

  • The surgeon will attach one end of the graft to the aorta, the main artery that carries blood from the heart to the body.

  • The surgeon will attach the other end of the graft to the coronary artery below the blockage.

  • The surgeon will create a new opening in the coronary artery above the blockage.

  • The surgeon will connect the graft to the coronary artery at the new opening.

  • If you are having on-pump CABG, the surgeon will take you off the heart-lung bypass machine.

  • The surgeon will close the incision in your chest.

Coronary Artery Disease (CAD) Symptoms

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Benefits of Coronary Bypass Surgery

Coronary artery bypass graft (CABG) surgery has a number of benefits, including:

  • Improved blood flow to the heart: CABG surgery creates new pathways for blood to flow around blocked or narrowed coronary arteries. This can improve blood flow to the heart muscle and reduce the risk of chest pain, heart attack, and other heart problems.

  • Reduced risk of death: CABG surgery has been shown to reduce the risk of death from heart disease in people with severe coronary artery disease.

  • Improved quality of life: CABG surgery can help people with coronary artery disease to live longer and more active lives. Many people who have CABG surgery report a significant improvement in their quality of life after surgery.

Other potential benefits of CABG surgery include:

  • Reduced risk of stroke

  • Improved exercise tolerance

  • Reduced need for medications

  • Improved sleep quality

  • Reduced symptoms of depression and anxiety

It is important to note that CABG surgery is not a cure for coronary artery disease. However, it can be a very effective treatment for people with severe coronary artery disease.

Risks of Coronary artery bypass graft (CABG) surgery

Some of the most common risks of CABG surgery include:
  • Bleeding: CABG surgery involves cutting through your chest and heart, so there is a risk of bleeding during and after the surgery.

  • Infection: There is also a risk of infection at the incision site or in the chest cavity.

  • Heart attack: CABG surgery can put stress on your heart, and there is a small risk of having a heart attack during or after the surgery.

  • Stroke: CABG surgery can also increase your risk of having a stroke, especially if you have other risk factors for stroke, such as high blood pressure or diabetes.

  • Arrhythmias: CABG surgery can cause arrhythmias, or irregular heart rhythms. Most arrhythmias are temporary and go away on their own, but some arrhythmias may require treatment.

  • Kidney problems: CABG surgery can also put stress on your kidneys, and there is a small risk of developing kidney problems after surgery.

  • Death: CABG surgery is a safe procedure, but there is a small risk of death associated with any surgery.

The risks of CABG surgery are higher for people with certain medical conditions, such as diabetes, obesity, and severe lung disease. Your doctor will talk to you about your individual risks and benefits before making a recommendation about CABG surgery.

If you are considering CABG surgery, be sure to ask your doctor about all of the potential risks and benefits. It is also important to understand the recovery process and what to expect after surgery.

Coronary Artery Bypass Surgery Recovery Time

Recovery from CABG typically takes 6 to 12 weeks. Most people will spend 5 to 7 days in the hospital after surgery. During this time, you will receive pain medication, breathing assistance, and other treatments to help you recover. You will also be taught how to care for your incision and how to perform exercises to strengthen your heart and lungs.

Here is a general timeline of CABG recovery:

  • Week 1: You will likely be tired and have some pain around your incision. You will need to take it easy and avoid strenuous activity.

  • Weeks 2-4: You will start to feel more like yourself and will be able to do more activities. You may still have some pain around your incision, but it should be less severe.

  • Weeks 5-6: You should be able to return to most of your normal activities. You may still experience some fatigue, but you should be able to manage it.

  • Weeks 7-12: You should be fully recovered from surgery. You can resume all of your normal activities, including work and exercise.

Of course, everyone heals at their own pace. Some people may recover more quickly, while others may take longer. It is important to listen to your body and not push yourself too hard.

Here are some tips for a healthy recovery from CABG:

  • Get plenty of rest. Your body needs time to heal, so make sure you are getting enough sleep.

  • Eat a healthy diet. Eating nutritious foods will help your body heal and will also help to lower your cholesterol and blood pressure.

  • Avoid smoking. Smoking can damage your heart and lungs and can slow down your healing.

  • Exercise regularly. Exercise is important for your overall health and can help you to recover from surgery. Start slowly and gradually increase the amount of exercise you do as you feel better.

  • Take your medications as prescribed. Your doctor will prescribe medications to help prevent blood clots and to lower your cholesterol and blood pressure. It is important to take these medications as prescribed to help you recover from surgery

Coronary Artery Bypass Surgery Cost in Delhi

The cost of bypass surgery in Delhi -NCR- can vary widely depending on several factors, including the location of the hospital, the experience of the surgeon, and the complexity of the procedure.

Approximate Cost Breakdown for On-pump Coronary Artery Bypass Surgery in Delhi

Approximate Cost Breakdown for On-pump Coronary Artery Bypass Surgery in Delhi

Expense Category Description Approximate Cost Range
Hospital Charges Includes room charges, nursing care, and facilities ₹1,00,000 - ₹1,50,000
Surgeon's Fee Fee charged by the cardiac surgeon ₹70,000 - ₹1,00,000
Anesthesia Cost of anesthesia during surgery ₹30,000 - ₹50,000
Medications Prescribed medications during and after surgery ₹10,000 - ₹20,000
Diagnostic Tests Pre-operative and post-operative tests ₹10,000 - ₹20,000
Cardiac Rehabilitation Cost for post-operative rehabilitation programs ₹10,000 - ₹20,000 (per month)
Miscellaneous Expenses Additional expenses, such as medical supplies, etc. ₹5,000 - ₹10,000

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