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Coronary Artery Bypass Graft Surgery in Gurugram

Coronary Artery Bypass Graft Surgery

Coronary Artery Bypass Graft Surgery in Gurugram

A Coronary Artery Bypass Graft (CABG) treats Coronary Artery Diseases. Coronary Artery Disease (CAD) occurs due to the narrowing of the Coronary Arteries, which may obstruct blood flow. The blood vessels narrow due to the accumulation of plaque or fatty material inside the artery's walls. As a result, the supply of oxygen-rich blood and nutrients to the heart muscles gets limited.
Doctors commonly perform CABG as open-heart surgery. However, less invasive techniques like 'Off-pump' procedures, Robotics and Keyhole Surgery are also available to bypass the blocked coronary artery.

Why Is It Done?

The doctors recommend Coronary Artery Bypass Graft Surgery to treat the narrowed or blocked coronary arteries. The symptoms of Coronary Artery Disease are:

  • Chest pain

  • Palpitations

  • Abnormal Heart Rhythms

  • Shortness of breath

  • Fatigue

  • Indigestion

  • Swelling in the hands and feet

Early detection of Coronary Artery Disease is difficult as there may or may not be any symptoms. However, if the blood supply to the cardiac muscles decreases, the patient may get a heart attack. 

Risks

A Coronary Artery Bypass Graft has the following associated risks.

  • Excessive bleeding during or after the surgery.

  • Blood clotting results in heart attack, stroke, or lung problems.

  • Abnormal heart rhythms

  • Kidney failure

  • Infection

  • Breathing problems

  • Pneumonia

  • Failure of the graft

  • Pancreatitis

The surgery complications depend upon the patient's pre-existing medical conditions.

Preparation

  • The doctors will ask the patients for several blood tests, and imaging diagnostic tests before the surgery. 

  • Patients undergo a thorough physical examination. 

  • The doctor reviews the patient's medical history.

  • The doctor provides the dietary and medication restrictions before the procedure.

  • The doctor may ask the patient to clean with a medicated solution before the surgery. 

  • It is advisable to quit smoking before the surgery as smoking decreases the chances of recovery.

The patient must discuss the following with the doctor to avoid complications later.

  • Understand the procedure.

  • Allergies and sensitivity to specific medicines, tape, latex or anaesthetic medications.

  • Prescription, over-the-counter medicines and herbal supplements if any being taken.

  • Blood thinning medicines.

  • Conditions like pregnancy and pacemaker implants.

Expectation

Before The Procedure

  • The patient has to remove the jewellery or other objects that may interfere during the procedure.

  • The patient changes into the hospital gown.

  • The patient needs to empty their bladder.

During The Procedure

  • The medical staff will continuously monitor the patient's blood pressure, heart rate, breathing, and oxygen level during the surgery.

  • The patient is given general anaesthesia for the procedure. Once they sleep, the doctors start the procedure. 

  • The surgeon inserts a tube into the throat to connect it to a ventilator.

  • The surgeon inserts an IV line in the arm or hand.

  • The surgeon inserts catheters in the neck and wrist to monitor blood pressure and pulse and take blood samples.

  • The surgeon also inserts a catheter to drain the urine.

  • The surgeons make incisions in the legs or wrists to access the blood vessels for the grafts. 

  • The surgeon makes a large incision from below Adam's apple to below the navel. They will cut the sternum (breastbone) in half lengthwise and separate and spread the halves to expose the heart.

  • Next, the surgeons clean the incision site with an antiseptic solution.

Coronary Artery Bypass Graft Surgery 'On Pump' Procedure

  • The doctor will temporarily stop the heart to sew the grafts onto the coronary arteries. They will connect a heart-lung bypass machine that will mimic the pumping organ.

  • The doctor stops the heart as they inject a cold solution.

  • The surgeon sews one end of the section of the vein over a tiny aorta opening and the other over a tiny Coronary Artery opening just below the blockage.

  • Depending on the number of blockages, the patient may need more than one bypass graft. After the doctors have sewn the grafts, they will check by running blood through them.

  • Once the doctors check the grafts, they will divert the blood from the bypass machine into the heart and remove the tubes.

  • The heart may require a mild electric shock to restart. 

  • The doctors will connect the patient to a temporary pacemaker to regulate the heartbeats during the initial recovery period.

Coronary Artery Bypass Graft Surgery 'Off Pump' Procedure

  • After opening the chest, the doctors will stabilize the area around the blocked artery with the help of an instrument.

  • The rest of the heart functions as it is.

  • The doctors will sew one end of the section of the Aorta vein opening and the other over the coronary artery.

  • Depending on the number of blockages, the patient may need more the one bypass graft.

  • The doctors will closely monitor the grafts before closing the chest.

  • During the procedure, the doctors keep the heart-lung bypass machine on standby.

Procedure Completion

  • The doctors sew the sternum using small wires and sew the skin over it.

  • The surgeon inserts a tube into the patient's chest and drains the fluids, including blood from around the heart. 

  • The surgeon also inserts a tube into the stomach via mouth or nose to drain the fluids.

  • Next, they will apply a sterile bandage over the incision.

After the Procedure 

The patient stays hospitalized for a few days post-surgery.

  • The patient stays in the Intensive Care Unit (ICU) after the surgery. The healthcare team closely monitors the blood pressure, breathing rate, heart rate and oxygen levels. 

  • The doctors will remove the breathing tube as the anaesthesia wears off and the patient is stable enough to breathe and cough. Nurses will help the patients with breathing exercises every few hours to avoid the collection of mucus in the lungs. 

  • The patient may get pain-relieving medicines.

  • After the patient is stable, the doctors remove the breathing and stomach tubes. 

  • The patient initially stays on a liquid diet and gradually moves to a solid foods diet.

  • The patient goes to the post-surgical nursing unit for further recovery. Here, the nursing staff will help the patient relearn to walk, for some time. 

  • The doctors will determine if the patient is fit to return home. They will give bathing instructions and medicines and schedule a follow-up appointment.

Visit our hospital if you need Coronary Artery Bypass Graft Surgery in Gurugram. 

At Home

  • The patient must keep the surgical area dry and clean.

  • They should avoid driving and strenuous physical activities.

  • The patient must immediately contact the doctor if there are any of the following symptoms:

  • Bleeding, swelling, or redness at drainage or incision sites.

  • Increase in pain.

  • Irregular pulse.

  • Persistent nausea or vomitingHigh fever.

  • Chills.

  • Swelling in the legs.

Results 

  • Recovery after the CABG procedure takes time. The patients usually recover completely in 12 weeks. 

  • Recovery time differs for each and may be subject to one's medical condition and post-surgery care.

Why Choose Manipal Hospitals?

Manipal Hospitals are the pioneers in cardiac surgeries. The Department of Cardiology boasts state-of-the-art facilities, the latest medical technology and equipment and a team of multidisciplinary Doctors, Cardiologists, Anaesthesiologists, Internists and Surgeons.

Trained and expert interventional cardiologists can tackle all types of cardiac cases. The healthcare team is compassionate and caring towards the patient and helps them with their post-surgical recovery. 

At Manipal Hospitals, the patients are the priority, and we take utmost care to ensure a smooth heart treatment.

Frequently Asked Questions (FAQs)

  • For how long does the heart remain stopped during CABG?

The surgeons temporarily stop the heart for around 30-90 minutes during the bypass surgery. A heart-lung bypass machine mimics the heart's function.

  • Is there a common complication in CABG?

Bleeding is a concern for the doctors performing the CABG. The doctors continuously monitor the patients to prevent excessive bleeding during and after the surgery.

  • Which blood vessel do the doctors prefer as a graft?

The doctors may use any of the following vascular conduits for CABG:

  • Internal Thoracic Artery (ICA).

  • Right Gastroepiploic Artery (RGEA).

  • Splenic Artery.

  • Ulnar Artery.

  • Inferior Epigastric Artery.

  • Saphenous Vein (SV).

  • Radial Artery (RA).

  • How long does the patient remain hospitalized after CABG surgery?

The patient stays in the hospital for 5-7 days after the CABG.

  • What are the precautions after CABG?

  • Avoid smoking.

  • Avoid strenuous physical activity.

  • Do not drive.

  • Sternal precautions include instructions related to the movement of arms.

Summary

  • Coronary artery disease (CAD) occurs when the blood vessels carrying the oxygenated blood to the heart muscles get narrow. It is a result of the accumulation of fatty material inside the walls of the arteries. It causes a decrease in the blood flow to the heart. 

  • A Coronary Artery Bypass Graft (CABG) surgery treats Coronary Artery Disease. It is an open-heart surgery. Some associated risks are infection, bleeding, clotting, irregular heartbeat, breathing problems, pneumonia, kidney failure and pancreatitis. 

  • The patient is given general anaesthesia for the procedure. The surgeon makes a large incision to access the heart. The incision happens across the chest. 

  • The surgeon also makes incisions in the legs or wrists to access the blood vessels for the grafts. Depending on whether the procedure is 'on pump' or 'off-pump', the surgeons will perform the process further. 

  • In the 'on-pump' procedure, the doctors temporarily stop the heart and use a heart-lung bypass machine. They sew one end of the section of the vein over a tiny aorta opening and the other over a 'small opening' made in the coronary artery just below the blockage. The patient may need more than one bypass graft. After the doctors have sewn the grafts, they will check by running blood through them. 

  • In the 'off-pump' method, the doctors stabilise the area around the blocked artery with an instrument. The heart functions as it performs the surgery.

  • The patient stays in the hospital for several days after the surgery. 

  • The recovery usually takes around 12 weeks.

Experience world-class healthcare at Manipal Hospitals. Our expert team of doctors and state-of-the-art facilities ensure personalized and advanced treatments. Take the first step towards wellness. Book an appointment today.

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