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What is CABG? Coronary Artery Bypass Grafting, commonly referred to as bypass surgery, is a surgical intervention that aims at restoring normal blood flow through the coronary artery by creating a separate passage that bypasses the blocked or narrowed section of the coronary artery.

When is CABG performed? CABG is performed on patients suffering from CAD (Coronary Artery Disease), a condition marked by the build-up of plaque in the arteries. Plaque is a waxy deposit of cholesterol, that gradually builds up in the arteries and blocks them, leading to atherosclerosis. When this happens in the coronary artery, it is commonly referred to as CAD or ischemic heart disease.

When should you see a doctor? In case of angina and breathlessness, you should book an appointment with your doctor and get yourself evaluated. Your doctor will suggest when you need to undergo the procedure. However, in the case of a heart attack, the patient should be immediately rushed to the hospital where CABG might be performed on an emergency basis.

What causes CAD? Coronary artery disease can be a result of damage or injury caused by any of the following:
• Excessive smoking
• Hypertension
• Uncontrolled cholesterol
• Diabetes
• Sedentary lifestyle

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What are the benefits of CABG? arious benefits of the CABG procedure are:
• Relief from symptoms like chest pain and breathlessness in patients who are not responding to medical therapy
• Better quality of life with long term survival and return to normal day to day activities
• Alleviates the risks of potential heart problems like arrhythmia
• Lowers the need for transfusion
• The procedure can be performed to treat multiple blockages simultaneously

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How safe is CABG? CABG may be performed as a pre-planned procedure or on an emergency basis, depending upon the need of the situation. It is a safe procedure that helps to alleviate the risks of heart attack and death caused by CAD.

Is CABG painful? You are likely to experience pain and discomfort for some time following the procedure, however, these can be easily managed with medication. You may also experience soreness at the surgical site. The symptoms may last for a few weeks.

Different types of CABG

CABG procedure is broadly classified into 3 types Traditional coronary bypass grafting - It is the most common type of CABG, which is recommended when one of the major arteries has been affected. The procedure involves the relocation of the sternum and the use of a heart-lung bypass machine.

Off-pump coronary artery bypass grafting - The procedure is quite similar to traditional CABG, as it involves the relocation of the chest bone. The only difference is that it does not require a heart-lung bypass machine. This is the reason why the procedure is also referred to as beating heart bypass grafting.

Minimally invasive direct coronary bypass grafting - MIDCAB procedure is carried out without the use of a heart-lung bypass machine, and uses a minimally invasive approach to treat the blockage. It is performed when the affected blood vessel is right in front of the heart.

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How to prepare for CABG? • Make sure that your doctor is aware of every medicine that you are, or have been taking
• IV drips will be inserted to administer medicines and other fluids and your vitals will be recorded
• This is followed by making a large incision on the patient's chest and cutting through the sternum, to access the heart.
• The doctors will then carefully sew the graft on the other side of the blockage. As this is being done, your heart will be stopped temporarily and you will be put on a heart-lung bypass machine.
• The procedure may be done for more than one blockage and once all the blockages are cleared, the blood is allowed to run through the new passage.
• Doctors will carefully examine the flow of blood to determine if the grafts are working properly.
• In some cases, the doctors may insert a pacemaker to help your heart function normally during the initial stage of recovery

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How is the procedure done? • The procedure takes about 3 to 6 hours and is performed under the influence of general anaesthesia.
• IV drips will be inserted to administer medicines and other fluids and your vitals will be recorded
• This is followed by making a large incision on the patient's chest and cutting through the sternum, to access the heart.
• The doctors will then carefully sew the graft on the other side of the blockage. As this is being done, your heart will be stopped temporarily and you will be put on a heart-lung bypass machine.
• The procedure may be done for more than one blockage and once all the blockages are cleared, the blood is allowed to run through the new passage.
• Doctors will carefully examine the flow of blood to determine if the grafts are working properly.
• In some cases, the doctors may insert a pacemaker to help your heart function normally during the initial stage of recovery

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What to expect after the procedure? • fter the procedure, you will be shifted to the ICU for a day or two, for keen observation.
• After the procedure, you will be shifted to the ICU for a day or two, for keen observation
• After gaining consciousness you will be shifted to your room
• Fluids and medicines, to control normal blood circulation and blood pressure, will be given intravenously
• If the doctors feel the need, you will receive oxygen therapy or a temporary pacemaker while you are in the ICU
• Your vitals will be carefully monitored throughout your stay
• You will be discharged within a week
• You will, however, be required to go for regular follow-ups, as suggested by your doctor


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