Coronary artery bypass grafting (CABG) or heart bypass surgery is performed to replace blocked arteries .Coronary arteries are the sole supply of pure oxygenated blood to heart when they are blocked,a bypass surgery provides the heart with pure oxygenated blood via alternate routes. The damaged arteries are usually replaced by taking blood vessel(s) from some other part of the body, preferably from the chest,legs or arms. After a successful surgery, the functional blood vessel restores normal blood flow to the heart. DrDinesh Kumar Mittal from Max Healthcare – one of the best heart hospitals in India states that any delay in the treatment may lead to heart failure/sudden death.
What Causes Damage to The Coronary Artery?
Any damage or injury to the inner layer of the artery can lead to coronary artery disease. Various factors that may contribute in causing damage include obesity, stress, inactive lifestyle, smoking, high cholesterol and blood pressure and Diabetes Mellitus.
The Types of Bypass Heart Surgery
Depending on the number of arteries blocked, the doctor suggests the specific type of bypass required. These include:
|Single Bypass||Blockage in one artery|
|Double Bypass||Blockage in two arteries|
|Triple Bypass||Blockage in three arteries|
|Quadruple Bypass||Blockage in four arteries|
|High risk bypass||Blockage in arteries with decreased cardiac function.|
Any damage to the arteries mostly affects the left ventricle – the primary pumping chamber of the heart. A bypass surgery is only recommended when coronary arteries are so severely blocked that the patient has an increased risk of a heart attack or failure and the condition cannot be managed with medications. Do you know the higher the number of blocked arteries the longer the duration of the surgery!Alternatively, there are many conditions that can cause complications during the surgery or eliminate the possibility of performing one. These conditions includeperipheral arterial disease (PAD), kidney disease, lung disease,uncontrolled diabetes & neurological disorders.
Patients are always advised to discuss the above-mentioned conditions well in advance with their doctor before scheduling the surgery. Informing the doctor about the ongoing medications and medical history is also the right thing to do for a positive outcome after surgery.
How Is a Bypass Surgery Performed?
The surgeon harvests a potential graft (blood vessel) from thechest,arms, and legs and attaches one end to coronary artery after the blockage. The other end is either attached to aorta or is a directly flowing vessel with natural blood supply like vessels of chest .The new blood vessel creates a new route for the blood to travel smoothly to heart. In cases where there are multiple blockages, the surgeon performs multiple bypass procedures during a single surgery. The patient is under general anesthesia during the surgery that takes about three to six hours on an average.
After the surgery, the patient is shifted to the ICU for two to three days depending on the condition and then to the nursing unit for about five days before discharge. Because bypass surgery is invasive, the recovery time is longer and may take four to six weeks.
Patients should keep in mind that a bypass surgery does not cure the underlying cause of the blockage; hence lifestyle modifications advised by the doctor should be strictly adhered. With a good control one can expect a very long and healthy lifestyle after surgery.
Are There Any Alternatives to Bypass Surgery?
Yes there are other alternatives !though not always as affective as bypass surgery ,they do improve the quality of life
Medication – As stated earlier, there are many conditions that may eliminate the chances of performing a CABG. In such cases, the doctor prescribes certain drugs that reduce cholestrol and plaque buildup and relieve stable angina.
Balloon Angioplasty–Though balloon angioplasty is not as effective as coronary artery bypass grafting, it is one of the most recommended alternatives and is less risky as well. The procedure involves the use of a tube that is threaded to the blocked artery and a balloon is inflated to widen the artery. After the tube and the balloon are removed, a stent is placed in the artery to keep it away from contracting back.
Enhanced External Counterpulsation (EECP) – EECP is suitable for those who have – chronic stable angina, nitrates are not causing any relief in angina and those who cannot undergo a bypass surgery. It is a non-invasive, outpatient therapy that is performed everyday over the course of seven weeks.
How to Prevent Coronary Artery Disease?
Having an active schedule, low cholestrol diet, maintaining a healthy weight, quitting smoking and controlling stress and high-blood pressure can keep one away from developing a coronary artery disease. Doctors also advise to consume a low fat and low salt diet that is rich in whole grains, fruits and vegetables.