What is a coronary arteray bypass graft?
In a CABG operation the surgeon grafts other blood vessels onto the patient’s Robotic CABG
the diseased portion. This creates a new pathway for blood flow that ensures the delivery of oxygen and nutrients to the heart muscle. In the picture below two areas of blockage in coronary arteries have been bypassed in order to restore blood flow to the heart. Two commonly used vessels have been chosen, one from the leg and one from the chest area
There are three main coronary arteries:
Left anterior descending artery
Right coronary artery
What are coronary arteries & coronary artery disease?
Coronary arteries are blood vessels that carry blood, oxygen and other nutrients to the heart tissue to help it work effectively. As we get older our coronary arteries may become hardened and fatty deposits can build up on the inner lining of the vessel. This process (atherosclerosis) is what causes narrowing of the coronary arteries, where blood supply to heart muscle is reduced and symptoms of coronary artery disease usually begin.
Poor or abnormal function of the cardiovascular system
May be a result of:
Insufficient blood supply due to dehydration, bleeding or swelling;
A poor blood supply to the heart, where there is not enough oxygen and other nutrients for its work;
Poor lung function or obstruction to blood flow in the lungs, which places a strain on the heart muscle;
Too many or too few electrolytes (eg. potassium, magnesium) that cause irregular heartbeats or dangerous rhythms in the heart.
Weakness of blood vessel walls.
Heart muscle weakness
What are the possible complications following CABG?
All surgery carries risks of complications. Possible complications following cardiac surgery include:
- Arrhythmia – irregular heart beat
- Excessive bleeding – may require returning to the operating theatre and a blood transfusion may be necessary
- Stroke – debris from the inner lining of the aorta (major blood vessel) can break off and lodge in the brain
- Infection – may occur in leg, arm or chest wound or in the chest
What are the benefits of surgery?
The main benefit is to reduce angina. Surgery may also improve your breathlessness and how well your heart works. Sometimes surgery can reduce the risk of you having a heart attack.
Are there any alternatives to surgery?
For some people it may be possible to have a percutaneous coronary intervention (PCI) to widen or unblock an artery using a small inflatable balloon. Coronary artery disease can be treated using drugs.
What does the operation involve?
The operation is performed under a general anaesthetic and usually takes about three hours. Your surgeon will make a cut down the front of your chest, through the breastbone. You will be connected to a heart-lung machine, which allows the heart to be still while the open heart bypass surgery
Your surgeon will use a length of blood vessel, taken from elsewhere in your body, to bypass the blockage and so restore a good blood supply to your heart
What complications can happen?
General complications of any operation
Specific complications of this operation
Infection in the chest wound
What is life like after CABG surgery?
Following transfer from ICU to the ward the patient will have the support of a multi disciplinary team to help get them back on their feet and ready for home. This team consists of doctors, nurses, physiotherapists, occupational therapists, dieticians, pharmacists, and social workers. The team gives advice on exercise guidelines and provides a program is for the patient to return to usual activities for the weeks after discharge from hospital.
The patient is encouraged to attend a cardiac rehabilitation program that offers education sessions and supervised exercise programs. It also provides a valuable opportunity to meet with other people who have recently had heart bypass surgery
How soon will I recover?
After the operation you will be transferred to the cardiac intensive-care unit or high-dependency unit, usually for 24 hours, and then to the ward.
You should be able to go home after seven to ten days.
Your surgeon, physiotherapist and occupational therapist will tell you when you can return to normal activities.
Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, you should ask a member of the healthcare team or your GP for advice. You should make a good recovery, with relief of angina. However, symptoms can sometimes come back
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