Coronary Artery bypass grafting surgery CABG
Coronary artery bypass graft surgery in Israel is a surgical procedure that allows to bypass the blood flow around an area of a blocked or partially blocked heart artery. As a result of this procedure, blood flow to the heart muscle improves.
We cooperate with the leading Israeli cardiac surgeons, heads of cardiac surgery departments and research institutes, which have many years experience in CABG procedure.
Our cardiac surgeons perform coronary artery grafting surgery at one of the biggest Israeli hospitals – Assuta.
During coronary artery bypass grafting a healthy blood vessel is removed from the patient’s arm, leg, or chest area and connected to other arteries of the heart. Thus, blood bypasses a diseased or blocked area.
After coronary artery bypass surgery, symptoms such as chest pain and shortness of breath due to poor blood flow to the heart tend to disappear. Such a surgery helps to improve heart function and reduce the risk of death from cardiovascular disease.
Our doctor may consider coronary artery bypass grafting in a variety of ways – using open surgery or angioplasty or stenting. It depends on the individual patient parameters and is determined during the diagnostic coronary angiography of the heart vessels (catheterization).
Coronary artery bypass grafting is usually indicated if:
♦ The patient feels severe chest pain caused by the narrowing of several arteries supplying the heart muscle, even during light exercise or rest.
♦ Some patients benefit from angioplasty and stenting, for others coronary bypass surgery may be the best option.
♦ The patient has more than one diseased coronary artery and the left ventricle is not functioning properly.
♦ The left coronary artery of the heart is greatly narrowed or blocked.
♦ There is clogging of the arteries, in which case the angioplasty is not suitable, or there was an unsuccessful angioplasty or stent placement, as a result of which the artery narrowed again (restenosis).
♦ Coronary artery bypass grafting can also be performed in emergency situations, such as a heart attack, if the patient does not respond to other treatments.
After coronary bypass surgery lifestyle changes are still a necessary part of treatment. It is also necessary to take medications to lower blood cholesterol, reduce the risk of blood clots, and promote heart function.
Preparation for coronary artery bypass grafting
Our doctor will give specific instructions as for any restrictions on activity and changes in the diet or the need for certain medications.
Before the operation, it is necessary to undergo diagnostic procedures, such as chest x-ray, blood tests, ECG and coronary angiography using a contrast medium to visualize the arteries that feed the heart.
The coronary bypass procedure requires the use of general anesthesia and usually takes from three to six hours. The number of shunts depends on the location and severity of the blockages in the heart.
An open coronary bypass operation is performed through an incision in the chest. After the chest is opened, the heart is temporarily stopped and its function is temporarily transferred to a special apparatus, which continues to carry out blood circulation in the body.
The surgeon removes a healthy blood vessel, often inside the chest wall (inner thoracic artery) or from the lower leg, and attaches the ends above and below the clogged artery so that the blood flow is redirected (bypassing) around the narrowed part of the affected artery.
Other methods of coronary artery bypass grafting
The minimally invasive procedure allows to perform an surgery on a beating heart using special equipment to stabilize the area of the heart on which the surgeon operates. This type of operation is challenging because the heart is still moving. And this method is not suitable for every patient.
With minimally invasive surgery, our doctor performs coronary artery bypass grafting through a small incision in the chest, often using robotics with a camera and video on the screen, which help the surgeon to work in the damaged area. Variations of minimally invasive surgery can be called keyhole surgery.
After the introduction of general anesthesia, a breathing tube is inserted into the mouth, which is attached to the ventilator, it breathes instead of the patient.
After coronary artery bypass grafting
After surgery, the patient spends a day or two in the intensive care unit, where the work of the heart, blood pressure, breathing and other vital signs are constantly monitored. The breathing tube remains in the throat until the patient wakes up and begins to breathe on his own.
In the absence of complications, the patient is usually discharged after a week. The recovery period is from about 6 to 12 weeks.
The results of the surgery
After surgery, most people feel better and can remain without symptoms for 10 to 15 years.
Although bypass surgery improves blood supply to the heart, it does not cure the underlying coronary artery disease. Long-term results will depend, in particular, on medications taken to prevent blood clots, lower blood pressure, cholesterol and diabetes, as well as maintaining a healthy lifestyle (do not smoke, follow a healthy diet plan, maintain a healthy weight, regular exercise, stress management).
In addition to lifestyle changes, a heart rehabilitation program is often recommended. These are individual exercise programs designed to help a person recover from a heart attack, from other forms of cardiovascular disease, or after heart surgery. Cardiac rehabilitation often begins while the person is still in the hospital, and continues on an outpatient basis until normal heart function is restored.
The risks of coronary artery bypass grafting
The risk of complications is usually low, and depends on the patient’s health status before surgery. It is higher if the operation is performed as emergency and urgent, or if the patient has concomitant problems, such as emphysema, kidney disease, diabetes mellitus or blocked arteries in the legs (peripheral artery disease).
Complications of open coronary artery bypass grafting may include bleeding, heart rhythm (arrhythmias), chest wound infections, memory loss or trouble with clarity of thinking, which often improve within 6 to 12 months, kidney problems, stroke, heart attack, if a blood clot (blood clot) comes off shortly after surgery.