July 27, 2017

Coronary Artery Bypass Grafting

The coronary artery is an important vessel that directly supplies blood to the muscles of the heart. Coronary artery bypass grafting (CABG) is surgery that allows blood to circulate around a blocked portion of the vessel. This procedure is considered for those diagnosed with severe coronary heart disease (CHD).

What is coronary heart disease (CHD)?

Coronary heart disease is a condition where a substance called plaque builds up inside the arteries of the heart. It is important to have a supply of oxygen-rich blood to the heart, but plaque can narrow or block these arteries. Plaque is made up of fat, cholesterol, calcium, and other substances. If the blockage is severe enough, it can cause shortness of breath, chest pain, or even heart attacks.

What are the symptoms of CHD?

  • Chest pain (angina)
  • Feelings of heaviness, tightness, or pressure on the chest
  • Shortness of breath
  • Heart attack

Are there tests for coronary heart disease?

After reviewing your medical history and doing a physical exam, the doctor will use several tests to see how advanced the CHD is.

Commonly used tests include:

  • Electrocardiogram (ECG)
  • Stress test
  • Coronary angiography
  • Nuclear scanning (fluoroscopy)

What types of treatment are there for CHD?

Lifestyle changes:

  • Diet change: low fat
  • Quitting smoking
  • Weight reduction to lower blood cholesterol

Medication

Surgery: Coronary angioplasty or Coronary artery bypass

Coronary Artery Bypass Grafting (CABG) Surgery
Coronary artery bypass (CABG) is one of the most common types of open-heart surgery in the US, and is considered one of the most effective types of treatment.

What is a graft?

A graft is a healthy piece of tissue, artery, or vein is taken from another part of the patient’s body. Arteries that are most used for coronary grafts are:

  • Internal mammary arteries: found inside the chest
  • Radial artery: from the forearm
  • Saphenous vein: found along the inside of the leg
  • Inferior epigastric artery: along the stomach wall

The selected artery or vein is then connected (grafted), to the heart to go around (bypass) the blocked part of the coronary artery. This will allow blood to go around the blockage and carry oxygen-rich blood to the heart muscles. If more than one artery blocked, more than one bypass can be done. Patients can undergo double or even up to quintuple bypass.

Heart-Lung Machine

The heart-lung bypass machine is used to take over blood circulation functions from the heart and lungs. It is a highly controlled and monitored system that pumps oxygenated blood to the body, while it allows the surgical team to stop the heart. With the heart stopped, the surgeon can successfully perform the bypass.

Goals of CABG surgery for candidates:

  • Reduction of chest pain (angina)
  • Decrease the risk of heart attack
  • Improving quality of life
  • Increase heart healthiness
  • Allow patient to resume an active lifestyle