Coronary artery bypass surgery or CABG is a common procedure in the world. How much do you know about it? Here're a few questions that patients ask generally.
This article informs you about the operation known CABG. It explains what is involved before, during and after the operation. It also explains what the possible risks are and how you can make your operation a success. This leaflet is not meant to replace the information discussed between you and your doctor, but can act as the starting point when someone is advised this heart surgery.
Because you have a blockage or narrowing of the arteries supplying your heart muscles themselves, the circulation of blood (energy) to your heart is reduced. This becomes particularly noticeable when your heart requires more blood (energy) during walking or any physical activities and causes pain or breathing difficulty. Any further fall in the flow of blood (energy) may lead to constant pain with the risks of heart attack; permanent damage of heart muscles. This operation is to bypass the blocked arteries so that the blood (energy) supply is restored back.
Each human body is having extra arteries/veins (pipes); two Internal Mammary Arteries (IMA) in chest, two Radial Arteries (RA) in forearm and two saphenous veins in legs. Surgical team takes down these conduits (pipes) from their original site and uses them to bypass Heart Arteries using special threads.
The aim is to improve the blood supply to your heart itself and to relieve your symptoms. By doing this it is hoped to increase the distance that you walk or work you were doing before experiencing of symptoms.
There is no surgical alternative due to the position of the occlusion (blockage) within your coronary arteries. Also, you shall be referred for surgery only when all others means of treatment (medicines, angioplasty) are not suitable to restore back your heart muscle blood supply. So, whenever CABG is advised, it should be getting it done soon for better health of your health.
Although this is a major operation, the risk is approximately 1 % in normal scenarios. The risk to you as an individual will depend on your age, general fitness, and whether you have any medical problems apart from heart. Though complications are rare, but overall it does mean that some patients may have a fatal complication from their operation. The surgical team will try to prevent these complications and to deal with then rapidly if they occur.
The doctors will explain about what they think the risks of the operation are for you and what the risks are of not having the operation. Only you can decide whether you go ahead and have the operation. Nothing will happen to you until you understand and agree what has been planned for you. You have the right to refuse if you do not want the operation.
No. Anesthesiologist will administer few medicines in your body to make you sedated. There is a period of 30-40 minutes preparation before the anesthesia begins. In this period the anesthetist’s assistant will attach machines which measure your heart rate (sticky pads on your chest), blood pressure and oxygen levels (small sensor on your finger or ear lobe). Now days, CABG is reasonably pain free after operation also.
You will usually be admitted on the day before surgery. You will meet the anesthetist, who is a doctor with specialist training in anesthesia, the treatment of pain and the care of patients in the Intensive Care Unit. You also will meet councilor, who shows you video about your surgical journey in the hospital. They will be happy to answer your questions and discuss any worries that you have. You must carry all medical files and CDs along with you while coming to hospital.
You must quit it before surgery. Continued smoking will cause further damage to your arteries and your graft is more likely to stop working, and you are more likely to have complications from your operation. If you can stop smoking for a day or two your blood cells can carry more oxygen around your body. You are less likely to get a chest infection after the operation.
You can expect to be in hospital for up to 7 to 10 days. Along with surgeon, dietician and physiotherapist will decide when you are ready to go home. Your primary doctor at your place will be informed about your present condition and medicines.
You will be transferred to ICU after the operation. Once you are awake enough and are free of pain, we try to disconnect oxygen machine. You can start talking as much then onwards. You will have a drip (tube) into one of the veins in your arm, which is used to give you fluids, until you are able to eat and drink normally. The arterial and central venous line will be removed as your condition stabilizes. In next two days, we make sure you are pain free, walking and tolerating your food than we shift you to ward.
The surgical team may review you four weeks after discharge and then after if requires. You can contact the surgical team anytime if you have a problem.
Effectively, there is no strict rest advised. You can start little household work (cooking, staircase climbing, and sitting work) from very next day of discharge. This may be varying according to your clinical conditions. Certain thing like driving scooter is strictly prohibited for at least six weeks. You must listen to all instructions given to you by your surgeon/dietician/physiotherapist before taking discharge.
It is advisable to gradually increase the amounts of exercise and that you undertake lengthening the distance that you walk. Office or shop sitting job can be started two weeks after discharge from hospital. If you are involved in heavy-duty job than it should be started only after six weeks.
It is important you keep your wound areas clean. If a wound becomes red and there is a discharge you should seek advice from your surgeon as you may need antibiotics or further care. You will be sent home with list of medicines and you must take it regularly as and when charted.