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Coronary Artery Bypass Grafting(on pump)

  • Posted on- Jan 05, 2018
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Full form of CABG is coronary artery bypass grafting, and colloquially heart bypass or bypass surgery is a surgical procedure to restore normal blood flow to a specific coronary artery. A normal coronary artery transports blood to and from the heart muscle itself, not through the main circulatory system.

There are two main approaches. In one, the left internal thoracic artery (internal mammary artery) is diverted to the left anterior descending branch of the left coronary artery. In the other, a great saphenous vein is removed from a leg, one end is attached to the aorta or one of its major branches and the other end is attached to the obstructed artery immediately after the obstruction to restore blood flow.


What is the procedure of Coronary artery bypass grafting on the pump?

Patients who were scheduled for urgent or elective CABG- only procedures were screened for enrollment. Exclusion criteria were any clinically significant valve disease (i.e., moderate, moderate-to-severe, or severe valve disease), a status requiring immediate surgery, small target vessels or diffuse coronary disease, clinical reservations of the surgical team regarding patients with risk-factor profiles that predisposed them to an extremely high risk of an adverse event, or the inability or unwillingness of the patient to provide consent.

While in the preoperative holding area, patients underwent randomization with the use of an automated central telephone system in a blocked randomization scheme. Assignments of the patients were balanced for each attending surgeon.


How is Coronary artery bypass grafting is done?


A standard median sternotomy was performed in all patients. Observation details have been published previously. During the trial, various stabilization devices were used during off-pump surgery to provide a motionless surgical field. The use of one of these devices was required. Conversion from the assigned procedure to the other procedure was performed when clinically necessary.

Why is CABG performed?


Coronary artery bypass surgery is used by doctor for the treatment of blockage and narrowing of more than one or more coronary arteries for restoring the blood supply in heart. Your doctor uses coronary artery bypass graft surgery (CABG) to treat a blockage or narrowing of one or more of the coronary arteries to restore the blood supply to your heart muscle.

Symptoms of coronary artery disease may include:

  •  Chest pain
  •  Fatigue (severe tiredness)
  •  Palpitations
  •  Abnormal heart rhythms
  •  Shortness of breath
  •  Swelling in the hands and feet
  •  Indigestion

Usually, you might not have any symptoms during the early period of coronary artery disease, disease will continue until there are enough artery blockages to cause symptoms and problems. If the lowering down of blood supply in your heart muscle is continually decreasing for result to increase blockage in a coronary artery, you may have a heart attack. In case, if the blood flow isn’t restored for the particular area of the heart muscle affected, then in that case tissue will die.

 

How to get ready for CABG?



After explanation of procedure by your doctor, you are allowed to ask question.
You will be asked to sign a consent form that gives your permission to do the test. Read the form carefully and ask questions if anything is unclear.

Along with a review of your health history, your doctor may do a complete physical exam to make sure you are in otherwise good health before having the procedure. You may need blood tests or other diagnostic tests.

You will be asked to not eat or drink for 8 hours before the procedure, generally after midnight.
It will be prescribed by your doctor for taking bath with soap and special cleanser before the day you are going for surgery.

 Tell your doctor if you are pregnant or think you could be.
You should instruct your doctor before getting a medication if you are allergic to some medicine.
 Tell your doctor about all medicines (prescription and over-the-counter), vitamins, herbs, and supplements that you are taking.

Your doctor should be told before if you have any problems related to blood thinning while taking the medicines such as aspirin, or other medicines that affect blood clotting. You may be told to stop some of these medicines before the procedure.

A test will be done by your doctor for knowing the longest time period of your blood clotting.
Tell your doctor if you have a pacemaker or any other implanted cardiac device.
If you smoke, stop smoking as soon as possible. It increases the chances of success for a early recovery of surgery and health benefit.

 Based on your medical condition, your doctor may ask you to do other things to get ready.

What is the risk of CABG?



Possible risks of coronary artery bypass graft surgery (CABG) include:


  •   Bleeding during or after the surgery
  •   Blood clots that can cause heart attack, stroke, or lung problems
  •  Infection at the incision site
  •  Pneumonia
  •  Breathing problems
  •  Pancreatitis
  •  Kidney failure
  •  Abnormal heart rhythms
  •  Failure of the graft
  •  Death

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor before the procedure.


 The cost of CABG per patient varied from 7 Lakh to 21 Lakh (means 9 Lakh).


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