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Coronary Artery Bypass Graft Surgery

Coronary artery bypass surgery is performed when a person has severe blockages in one or more cardiac artery and the arteries are unsuccessfully treated by coronary angioplasty or coronary angioplasty is not indicated. The procedure, also known as a CABG procedure works on the heart to maximize blood flow to the delicate heart muscle. If you have severe coronary artery disease, it is likely you’ll need to have a coronary artery bypass graft surgery.

Coronary artery disease is a condition in which cholesterol and calcium plaques build up inside the coronary arteries and interfere with the oxygenation to the heart muscle. The plaques can harden and can rupture, acutely interfering with blood flow in the heart. When the arteries are just narrowed, the patient usually only gets chest pain, also called angina.

If a plaque accidentally ruptures, it can allow a blood clot to clog the artery, leading to an acute heart attack or myocardial infarction (MI). Those who have just had a heart attack and those who have severe coronary heart disease are candidates for a graft procedure. During the procedure, a healthy vein or artery from the person’s body is taken and connected to both ends of the artery that is blocked. Blood then flows through the grafted artery or vein, supplying vital oxygen to heart muscle. One or several arteries can be bypassed at the same time.

The coronary artery bypass graft surgery is the most common open heart surgery performed by cardiothoracic surgeons in the United States. It is done if there is a failed angioplasty or if the doctor feels that an angioplasty would not be effective. If an angioplasty is performed, its success is increased by having a stent placed inside the artery. If, on the other hand, you have the beginnings of heart failure, the doctor may go straight to coronary artery bypass graft surgery.

Purpose of Surgery

The main purposes of a coronary artery bypass graft surgery are the following:

• Helping the patient become more physically active.
• Improving the overall quality of life.
• Decreasing the number of episodes of angina pain.
• Making better the chances of survival.
• Decreasing the chance of having a heart attack.
• Allowing your heart to pump more effectively.

Most cases of coronary artery bypass graft are successful and the patient experiences a reduction or complete resolution of the angina pain. Most patients share that the results of the surgery last for at least ten to fifteen years. Many patients do live longer than they would have otherwise if they didn’t have the surgery.

Surgical Risks

There are significant risks associated with coronary artery bypass graft surgery. Some of these risks include the following:

• Getting a severe wound infection from the surgery.
• Losing a lot of blood, causing anemia or shock.
• Suffering from a greater degree of pain than average.
• Having a bad reaction to the anesthesia.
• Getting a fever from infection or inflammation after surgery.
• Having a stroke from surgery.
• Having an intraoperative heart attack.
• Dying during or after surgery.

Fevers tend to occur if the patient has irritability, poor appetite or post-operative chest pain. The pericardium around the heart and the lungs become inflamed and contribute to having the fever. Pericardial inflammation is common after open heart surgery and can cause a buildup of fluid between the heart and the pericardial sac. This can be dangerous and can necessitate removal of the fluid.

Some patients have poor memory, problems thinking clearly and problems concentration after this type of surgical procedure. Problems in general are more common in women and in patients who are elderly at the time of the procedure. Negative side effects like those listed above tend to dissipate after six to twelve months.

Risk of complications and death are greater if the patient is diabetic, has kidney disease, diseases of the lung, peripheral vascular disease or an emergency operation.