Coronary Artery Bypass Graft (CABG)
Javad Al Aeme
Brief Info about Javad Al Aeme Hospital
Javad Al Aeme hospital was founded in April 2000 on an area of 9645 square meters. The hospital is located in north-east of Iran in the city of Mashhad and is determined to provide health care for its patients, at the most exceptional level in heart and vascular care field in the country.
How this Procedure is Done
What is Coronary Artery Bypass Grafting?
In coronary artery disease, also known as heart bypass surgery,the blood vessels that supply oxygen and nutrients to the heart muscle will be narrowed. This problem, mainly caused by a build-up of fatty material within the walls of the arteries, restricts the supply of oxygen-rich blood to the heart muscle.The most effective way for resolving this issue is bypassing the blocked portion of the coronary artery through using healthy blood vessels which are typically from chest, arm or legs. The number of them highly depends on the severity of blockages.
This surgery can considerablyenhance poor blood flow to the heartand its function, alleviate symptomslike chest pain or shortness of breath, andlessen the risk of dying because of heart-related problems.
The pre-operative education and research is a very critical stage that patients should go through to make sure that their health-related problems will be solved. By consulting with knowledgeable and experienced surgeons, you will be given the chance to express your expectations and goals as well. They will understand your concerns and propose a satisfactory solution afterwards.
Considering the significance of all the stages that patients should pass through for tackling their health-related problems, Iranian experts are highly recommended since they are the ones you can easily trust to ask any question you have. They have extensive knowledge and invaluable experience specially in surgical treatments likecoronary artery bypass grafting. They carry out many operations successfully every year and can help you meet your needs. They will choose the most suitable procedure to address the problems you are dealing with, inform you of the whole operation, ensure a safe surgery, and clarify the healing process. Moreover, they will review your diet history to modify the eating habits you have had so far with the help of a skillful dietitian and determine the level of routine exercise you should have later on to maintain your health.
It’s important to note that if you decide to get these surgical treatments in Iran’s specialized clinics, you will be offered the most up-to-date services with a low cost. Thus, you can save considerable amount of money while traveling to this beautiful country for resolving all the issues related to your health.
Who Can Benefit From Coronary Artery Bypass Grafting?
This operation can be an effective solution for you if:
- You suffer from severe chest pain since some major arteries that supply your heart muscle have been narrowed or blocked.
- There is more than one blocked coronary artery.
- The artery blockage cannot be cleared by inserting a tiny balloon.
- You have previously undergone an angioplasty to hold the artery open but the issue has not been tackled.
The coronary bypass surgery is typically performed in a specialized hospital. Patients will receive medicines that make them fall asleep and stop your heart from beating for a short period of time. In this case, surgeons can easily connect the healthy blood vessels, called grafts, into the coronary arteries. You will be connected to a ventilator as well whichfully supports your breathing.
Traditional CABG is the most majorkind of CABG surgery that usually takes about three to six hours. The duration of your operation depends on the number of blocked arteries.
In the very beginning, surgeons make a large incision in the chest and stop the heart for a short time.They cut the breastbone in half lengthwise and spread it apart. Afterwards, some tubes will be inserted into the heart to pump the blood throughout the body by a heart-lung bypass machine.
Then, doctors will take a vein from the leg, arm, stomach, or chest and connect it to the blocked coronary artery. The new blood vessel can bypass the blocked portion to create a new path for blood flow to the heart muscle. Next, the heart will be restarted and blood flow will be restored. At this stage, surgeons will carefully examine the grafts to ensure that they are working properly and then sew the breastbone back together with a wire. A sterile bandage or dressing will be applied at the end to keep the site clean.
After undergoing this operation, you should stay in the intensive care unit of the hospital for about two days. You might stay longer if you have had other surgeriesas well. During this period, your surgeonwill recommend taking special medications and making some considerable changes in your lifestyle to ease the symptoms, treat your disease, and help prevent potential complications like blood clots. You will be connected to an electrocardiogram (ECG) as well which monitors your heart rhythm. Nurses will also check your vital signs, including your heart rate, blood pressure, and oxygen levels.After leaving the hospital, it’s better to ask someone to take care of you since the more your rest, the better you will feel. You may need to continue taking some medicines which can help you avoid some common complications such as chest pain and loss of appetite. These issues will be resolved within six weeks. During the first follow-up visit, your doctor will remove the stitches. Then, you will be permitted todo your daily routine activities and walk for a longer period.
In most cases the recovery process takes about six to twelve weeks or even longer considering your overall health condition.
This surgery can help you feel better and usually remain symptom-free for about ten to fifteen years. Nonetheless, it’s important to note that some other arteries might become clogged in the future and requireeither bypass or angioplasty.
After having this operation, you should follow your doctor’s instructions carefully and make the lifestyle changes recommended by your medical team. Some medications are generally prescribed to lower your blood cholesterol andminimize the risk of developing a blood clot.
You can ensure that the results of this surgery are long-lasting only if you take care of yourself. Indeed, you should control some diseases like diabetes, stop smoking, exercise on a regular basis, and manage your stress level.
- A cardiothoracic surgeon who works on your heart.
- An anesthesiologist who gives you medicine to make you fall asleep before the surgery, connects you to a breathing machine, and monitors your vital signs throughout the operation.
- A perfusionist who manages the heart-lung pump.
- Several nurses who assist specialists during the surgery.
Yes. There are some less invasive techniques that can be employed to bypass blocked coronary arteries. One of the main ones is called “Off-pump" procedure in which the heart does not have to be stopped and there is no need to use a heart-lung bypass machine. This surgery is more difficult to be carried out because the heart is beating and doctors cannot easily access blood vessels. Nonetheless, it is much safer for some individuals who may have a higher risk of complications from using a heart-lung bypass machine. These people mostly include elderlies and adults suffering from diabetes, kidney disease, or chronic lung disease.
Other minimally invasive operations like keyhole surgery and robotic procedures might be performed as well depending on your needs.
Other minimally invasive operations like keyhole surgery and robotic procedures might be performedas well depending on your needs.
They usually include:
- Chest pain
- Abnormal heart rhythms
- Shortness of breath
- Swelling in the hands and feet
It highly depends on your overall health conditions. You will have to set several follow-up visits with your doctor to make sure that your heart is functioning properly. Your doctor will also evaluate your progress and give you the essential instructions that must be carefully followed.
Majority of patients can resume sexual activity and drive within five to eight weeks. They can also go back to work after six weeks if their jobs do not involve strenuous physical activity.
Majority of patients can resume sexual activity and drivewithin five to eight weeks. They can also go back to work after six weeks if their jobs do not involve strenuous physical activity.
Majority of surgeons will suggest you to have a cardiac rehabilitation (rehab) program. The major reason is that they can considerably boost your strength and energy through exercise training. In addition, they can help you return faster to your daily routine. Also, through supervising your physical activity, rehabilitation programs will guide you in living a healthier lifestyle and lessen the risks of future heart-related problems.
There are several kinds of CABG. Coronary artery bypass grafting procedures range from traditional methods to less invasive surgeries like a robot-assisted technique that allows the doctor to carry out the operation with remotely controlled surgical instruments. Before selecting the best kind of treatment, specialists consider your overall health condition and the severity of your heart-related problems. Other factors include your age, build, weight, as well as the location and magnitude of plaque buildup. They will also talk to you about the other illnesses you may have like lung disease or hardened arteries in addition to the medications you regularly take.
However, in general, traditional heart surgery can be the most effective solution for many patients.
However, in general, traditional heart surgery can be the most effective solutionfor many patients.
Yes but you don’t need to worry about them since all of them will fade away if you follow your surgeons’ instructions carefully.
The most common ones include:
- Irritation or itching from healing incisions
- Swelling of the area where a vein was taken
- Muscle ache or tightness in the shoulders and upper back
- Fatigue, mood swings, or depression
- Difficulty sleeping
- Loss of appetite
- Chest pain around the site of the chest bone incision
Once grafting is done, your heart is restarted with mild electric shocks. The heart-lung machine is disconnected, and the fluid drainage tubes are inserted into your chest. Wires are used to enclose your chest bone and stitches or staples to close the skin incision. When you are able to breathe on your own, the breathing tube is eradicated.
Since a heart-lung machine is not used during off-pump CABG, fewer complications tend to happen. This is specially true in individuals who had suffered a stroke or "mini-strokes" in the past, who are over 70 years old, or candidates afflicted with diabetes, kidney disease, or lung disease. Other pros of off-pump CABG include decreased bleeding during the operation, smaller likelihood of infection and other complications and faster recovery.