CABG that expands as Coronary Artery Bypass Grafting is a medical procedure, performed to improve the low blood flow to the heart resulting from narrowing or blockage of arteries due to build-up of plaque. 

Why undergo this procedure?

Patients facing trouble with narrowed or blocked arteries in the heart can undergo this procedure. A CABG procedure can help open up the narrowed or blocked arteries, to allow the primary blood vessels, to supply blood, oxygen and other important nutrients to the heart. The arteries are restricted or blocked by the excess of plaque-fatty material within the walls of the arteries. This accumulation of plaque causes curbs the supply of rich oxygenated blood to the heart. Thus, increasing symptoms like a heart attack in some extreme cases. Hence, a procedure, such as CABG restores the flow of blood to the heart and reduces the chances of any severity. 

There are several factors such as unhealthy diet, smoking, high blood pressure, high cholesterol, diabetes, calcium and an inactive lifestyle that lead to the formation and accumulation of plaque, which is the prime cause of blockages in the arteries. This plaque is formed when the inner walls of the arteries are damaged or injured. This plaque -unhealthy build-up of substances – tends to get glued to the inner walls of the arteries, thereby curbing the blood flow which results in the system malfunction. 

What symptoms to watch out for?

A patient with a blocked artery can have the following symptoms:

  • Acute chest pain
  • Shortness of breath
  • Tiredness
  • Abnormal heart rhythm
  • Swelling in hands and feet
  • Severe indigestion
  • Palpitations

It may not always be easy to identify symptoms in all patients at the onset but eventually, the symptoms will show up with the increased accumulation of plaque and blockage. In some cases, the symptoms may occur only at a severe level, which could cause a heart attack if the blood flow is not restored to the affected area within a considerable time. Loss of time can cause heart tissue to die immediately.  

Who should opt for a CABG procedure?

A CABG procedure may be recommended by the doctor in the cases mentioned below:

  • When the left chamber of the heart dysfunctions as there is more than one compromised artery.
  • When the affected artery is the main artery in the left chamber of the heart.
  • When several artery blockages cause acute chest pain even while doing simple physical chores.
  • When a patient has been through several unsuccessful procedures such as angioplasty (a method that uses an inflated balloon for the removal of blockage) and stenting (a procedure that involves putting a wire mesh to refrain the artery from closing). Or in case the patient has suffered restenosis (narrowing of the arteries even after placement of stent). 
  • When a patient is responding to any other treatment after having suffered a heart attack.

What are the several types of CABG procedure?

  1. Conventional: This is the most common method to treat blockages of the main artery by opening the chest bone to access the heart and stopping it to connect it to a heart-lung bypass machine. To keep the heart alive, blood and oxygen to the tissue are supplied by the machine and meanwhile, the blockage is relieved by the surgeon. 
  2. Off-pump: Bearing similarity to a traditional CABG procedure, the surgeon gains access to the heart through an incision in the chest bone. However, in this case, the heart is neither stopped nor is placed on a bypass machine; instead, the surgeon treats the blocked or narrowed artery on the beating heart.  
  3. Minimally-invasive: This is a fairly new procedure that involves making several small incisions on the left side of the chest, amidst the ribs to get to the heart in place of going for a large cut in the chest bone. It mainly restores blood flow to the blood vessels in front of the heart. On the downside, the procedure has not proved to be that effective in severe cases or patients with more than one or two blocked or narrowed arteries.

 What is the entire CABG procedure?

The CABG redirects the flow of blood to the affected artery by utilizing healthy blood vessels from the leg veins, arm or chest and connects them to the blood vessels on the other side. This creates a bypass for the compromised artery so that it can be relieved of the blood flow, as the oxygen-rich blood can now be supplied to the affected area via the new passage. Depending on the severity of the case, the surgeon can choose to use one or more of the healthy blood vessels to bypass the affected artery. In one case, four major blocked arteries could be bypassed at once. 

CABG procedure has proven to the most sought after methods to correct blockages, leakages or narrowing of the coronary arteries. Since it is an open surgery therefore popularly called by the following names-bypass surgery, coronary artery bypass surgery or heart bypass surgery. 

What are the major goals and aims of the CABG procedure?

A CABG procedure is performed to improve the quality of life and fulfil goals such as:

  • Reducing angina
  • Enabling physical activities
  • Promoting an active lifestyle
  • Improving the pumping process of the heart
  • Increasing the chances of survival
  • Reducing the risk of heart attack and stroke
  • Overall upgrading the quality of life

 What are the risks and complications of a CABG procedure?

There may be certain complications involved in a CABG procedure such as:

  • Bleeding during or after the surgery
  • Heart rhythm not regular
  • Spread of Infection at the incision 
  • Clotting of blood
  • Memory loss
  • Kidney disorder
  • Pneumonia
  • Breathing problem
  • Pancreatitis
  • Graft failure
  • Stroke
  • Heart attack
  • Death

The list is not exhaustive since they depend on the condition of the patient. Most of the risks are minor and do not pose a threat to an otherwise healthy patient. The chances of risks are high in patients that have other chronic health conditions or in cases where the CABG procedure was performed in an emergency.

Overall, the success rate of this procedure depends on the changes in the way of living, habits and diet – such as timely medication, healthy diet, physical exercise and staying away from smoking, alcohol, stress. Also opting for healthy weight management and continuous monitoring through health-checkups can keep the heart-healthy.

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