Coronary Artery Bypass Grafting
The Human Heart
This is a four-chambered muscular organ, shaped and sized roughly like a man’s closed fist with two-thirds of the mass to the left of midline. The heart is located between the lungs, in the middle compartment of the chest.
This pumps blood through the blood vessels of the circulatory system. Blood provides the body with oxygen and nutrients, as well as assisting in the removal of metabolic wastes.
Coronary Heart Disease & Symptoms
Coronary heart disease (CHD) is a narrowing of the blood vessels that supply blood and oxygen to the heart. The most common symptom of coronary artery disease is angina, or chest pain. Angina can be described as a discomfort, heaviness, pressure, aching, burning, fullness, squeezing, or painful feeling in your chest. It can be mistaken for indigestion or heartburn. Angina may also be felt in the shoulders, arms, neck, throat, jaw, or back. Some other symptoms of coronary artery disease include:
- Shortness of breath.
- Palpitations (irregular heartbeats)
- A faster heartbeat.
- Weakness or dizziness.
Risk factors for Coronary Heart Disease
- High blood pressure (hypertension)
- High cholesterol
- Family history
- Peripheral artery disease
Diagnosis of Coronary Artery Disease
- Electrocardiogram (EKG)
- Stress tests
- Ultrasound imaging of the heart muscle
- Coronary angiography
- High speed CT scan
What is Angiography?
An angiography helps diagnose conditions that affect blood vessels and flow of blood through them. The image on an angiogram is used to plan surgeries involving the blood vessels, such as Coronary Artery Bypass Grafting (CABG) or Open Heart Surgery & coronary angioplasty (PTCA), which are performed to treat coronary heart disease.
How does coronary artery disease develop?
- Coronary artery disease (CAD) occurs when plaque (accumulated by fats and cholesterols) builds up in the walls of the arteries.
- When coronary arteries narrows more than 50 to 70%, the blood supply beyond the blockage becomes inadequate to meet the increased Oxygen demand.
- The heart muscle becomes starved of oxygen (ischemic) and patients often experience chest pain when the blood oxygen supply cannot keep up with demand.
- When a blood clot (thrombus) forms on top of this plaque, the artery becomes completely blocked causing a heart attack.
What is Coronary Artery Bypass Grafting (CABG) or Open Heart Surgery?
Coronary Artery Bypass Grafting or Open Heart Surgery is the most commonly performed procedure for treatment of patients with coronary heart diseases. A Cardiothoracic surgeon performs the procedure to bypass blockages or obstructions of the coronary arteries. The coronary arteries are the blood vessels that supply blood to the heart with oxygen and nutrients. The heart relies on these fuels as it works constantly to pump blood through the body. The heart never rests like the other muscles in the body, and it demands a constant supply of fuel day and night. The term ischemic heart disease refers to the condition when the heart does not get these fuels. When the heart is sufficiently ischemic (when the shortage of fuel is critical enough), the muscle begins to die. This condition may cause a “heart attack” or myocardial infarction.
How do patients recover after CABG surgery?
After the surgery, Sutures are removed from the chest prior to discharge and from the leg (if the saphenous vein is used) after 7 to 10 day. Patients are advised not to lift heavy weight or drive for the first four weeks to avoid any injury to the chest. Exercise stress testing is routinely done four to six weeks after CABG. Patients are also counseled to stop smoking, reducing weight and dietary fat, controlling blood pressure and diabetes, and lowering blood cholesterol levels.
1. Dr. Amit Pendharkar, Sr. Consultant – Cardiology, BLK Super Speciality Hospital, Near Rajendra Place Metro Station, Pusa Road, New Delhi – 110005, India.
He is an expert and having a rich experience in this field.
Profile Link: Dr. Amit Pendharkar
2. Dr. H. K. Agarwal, Sr. Consultant – Cardiology, Max Super Speciality Hospital, Saket Institutional Area, Saket, New Delhi – 110017, India.
4. Dr. S. S. Murthy, Sr. Consultant – Cardiology, Fortis Memorial Research Institute (FMRI), Tower A, Unitech Business Park, Block – F, South City 1, Sector – 41, Gurugram, Haryana – 122001, India.
Profile Link: Dr. S. S. Murthy
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