(CABG)

Coronary Artery Bypass Grafting (CABG) is a surgical procedure used to treat coronary artery disease (CAD), which occurs when the coronary arteries become narrowed or blocked by plaque, reducing blood flow to the heart muscle. CABG surgery aims to improve blood flow to the heart by creating new pathways, or “bypasses,” around the blocked or narrowed arteries.

Key Aspects of CABG Surgery:

1. Indications:

   • CABG is typically recommended for patients with severe coronary artery disease, especially when multiple arteries are affected, or when other treatments like medication or angioplasty are not sufficient.
   • It is particularly indicated in cases where there is a high risk of heart attack, significant symptoms like angina (chest pain), or impaired heart function.

2. Procedure:

   • Anesthesia: The surgery is performed under general anesthesia.
   • Grafting: The surgeon takes a healthy blood vessel from another part of the body—usually the leg (saphenous vein), arm (radial artery), or chest (internal mammary artery)—and attaches it above and below the blocked coronary artery.
   • On-Pump vs. Off-Pump:
     • On-Pump CABG: The heart is stopped, and a heart-lung machine (cardiopulmonary bypass) takes over the heart’s function during surgery.
     • Off-Pump CABG: The surgery is performed on a beating heart without the use of a heart-lung machine.

3. Types of Bypasses:

   • Single Bypass: One artery is bypassed.
   • Double, Triple, or Quadruple Bypass: Two, three, or four arteries are bypassed, respectively, depending on the number of blocked arteries.

4. Recovery:

   • Hospital Stay: Patients typically stay in the hospital for about 5-7 days, including time in the intensive care unit (ICU) immediately after surgery.
   • Recovery Time: Full recovery can take 6-12 weeks. Patients are advised to gradually resume activities and follow a cardiac rehabilitation program.

5. Risks and Complications:

   • Short-Term Risks: Bleeding, infection, heart attack, stroke, and complications from anesthesia.
   • Long-Term Risks: Graft failure, where the new grafted artery becomes blocked over time, requiring further treatment.

6. Outcomes:

   • CABG can significantly improve symptoms like angina, reduce the risk of heart attack, and improve survival rates in patients with severe coronary artery disease.
   • Lifestyle changes, such as a healthy diet, regular exercise, quitting smoking, and managing risk factors like high blood pressure and diabetes, are crucial for long-term success.

7. Alternatives:

   • Angioplasty and Stenting: A less invasive procedure where a balloon is used to open the blocked artery, and a stent is placed to keep it open.
   • Medications: Managing CAD with medications alone, though this is usually less effective in severe cases.