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Coronary Artery Bypass Grafting (CABG) is a major cardiac operation performed to treat ischemic heart diseases

Coronary artery bypass grafting (CABG) is a surgical procedure that aims to improve blood flow to the heart. CABG is advised for people with severe coronary heart disease, a condition in which plaque builds up inside coronary arteries. The coronary arteries supply oxygen and nutrients to the heart muscle.

People with coronary artery disease experience narrowing of coronary arteries. The bypass surgery may be done for single coronary artery, two or three coronary arteries.

Blood vessels or grafts are used for the bypass procedure. These vessels or grafts are actually pieces of veins extracted from leg, wrist or artery in the chest. The blocked or narrowed arteries are bypassed with a vein, so the blood flows through the new graft to reach the heart muscle. This whole process of extracting pieces of veins and creating a bypass for blood to flow is called coronary artery bypass surgery. During the CABG procedure makes use of the traditional ‘open heart’ procedure (breastbone or sternum is cut in half lengthwise), off-pump procedures, minimally invasive and robotic procedures.

WHO IS REFERRED TO CABG?

Patients with blockage or narrowing of coronary arteries may require an immediate CABG. The symptoms of coronary artery disease are seen as, chest pain, fatigue, palpitations, abnormal heart rhythms, shortness of breath, swelling in the hands and feet and indigestion. Any delay in CABG may lead to complete stoppage of blood flow to the particular area of heart muscle and leads to death of the heart tissue.

HOW DOES YOUR DOCTOR CONFIRM THE PRESENCE OF CORONARY ARTERY DISEASE?

The doctor looks for symptoms of CABG. To confirm the presence of coronary artery disease, the doctor may advise for tests like electrocardiogram (record the electrical activity of the heart), stress tests and combining echocardiography (ultrasound imaging of the heart muscle) with exercise stress testing.

HOW DO YOU PREPARE YOURSELF FOR THE CABG PROCEDURE?

You may be asked to fast for 8 hours prior to the bypass surgery. Use an anti-septic soap to shower on the night and morning of the surgery. Provide complete information to your doctor on your medical history, especially on use of anticoagulant (blood-thinning) medicines, and other medications that affect blood clotting. Instances where you have a pacemaker and smoking habit should be reported to your doctor.

WHAT ARE THE RISKS OF CABG?

In a few patients who have undergone CABG procedure, the risks are evident as blood clots, infection, pneumonia, breathing problems, pancreatitis and kidney problems, abnormal heart rhythms and bleeding, failure of the graft and death.

CONCLUSION

The CABG procedures have been highly successful and ensure a healthy heart condition for the affected. The overall rate of mortality due to CABG is only 3 – 4 percent. Heart attack and bleeding are the major causes of mortality in CABG patients. Significantly, health complications following CABG may be greatly seen in aged people (above 70), and those with poor heart muscle function, infection of coronary artery, diabetes and chronic lung or kidney disease.

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