Table of ContentsView AllTable of ContentsWhy It Is DonePreparing for SurgeryBefore the SurgeryDuring the SurgeryAfter the SurgeryFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Why It Is Done
Preparing for Surgery
Before the Surgery
During the Surgery
After the Surgery
Frequently Asked Questions
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CABG surgery is one treatment option for a blocked coronary artery. The main cause of this isatherosclerosis, a condition in which fatty deposits in blood vessels cause them to narrow and harden.
There are several reasons why CABG surgery may be needed:
CABG surgery may also be used in emergency situations, such as a heart attack if you are not responding to other treatments.
CABG surgery is generally indicated when coronary arteries have 50% to 99% blockage.
Preparations for a Double Bypass
Before the surgery, you may be asked to stop taking anyanticoagulant drugs(blood thinners) to prevent excessive bleeding. Antiplatelet agents such asBrilinta (ticagrelor) and Plavix (clopidogrel), are typically stopped one week prior to surgery.Some people who take systemic anticoagulant drugs likewarfarinmay be placed on a short-acting systemic blood thinner (such as heparin) before the procedure.
What is a coronary angiogram?
A coronaryangiogramis a special procedure used to assess blood flow through the arteries of the heart. During this procedure, contrast dye is injected into your coronary arteries through a small catheter and x-rays are taken to show how well your blood is flowing.
Basics of Inpatient Surgery
The surgery is performed undergeneral anesthesiato put you fully to sleep. In order for you to breathe, anendotracheal breathing tubewill be placed into your throat and connected to a mechanical ventilator. Yourvital signs(including pulse, blood pressure, and blood oxygen) will be monitored to ensure that you remain stable throughout the procedure.
Heparin, a type of blood thinner, will be administered intravenously (into a vein) to prevent blood clotting.
There are two types of CABG surgery your surgeon may perform:
Indications for Off-Pump Bypass
CABG surgery involves the harvesting of a vein to be grafted and the grafting of the vein into the heart (anastomosis).Radial artery grafting or utilization of the internal mammary arteries may also occur.
After the graft is placed, the heart will be restarted and checked for any signs of leakage. Once everything has been checked, your chest will be closed and your skin sutured or stapled shut.
Chest tubes are usually placed to drain fluids from the chest cavity, either with gravity or gentle suction. This prevents the build-up of blood and fluid around the heart.
Once CABG surgery is over, you are wheeled to a cardiac intensive care unit (ICU) to recover.
Unlike most procedures, the anesthesia used for CABG surgery is not reversed with medications. Instead, the anesthesia is allowed to wear off over the course of four or more hours, allowing you to slowly and gently wake up.
In most cases, you will be kept in ICU until the following day and transferred to a bed in the surgical ward. If there are no complications, you can usually be discharged in four days and provided with care instructions for you and your caregivers.
You will also be prescribed drugs to prevent postoperative complications, including:
You may experience postoperative side effects like insomnia, poor appetite, depression, and memory problems, but these tend to subside within six to eight weeks.A tailored exercise and diet plan will be provided to aid with your recovery.
You may also be referred to participate in acardiac rehabilitation program. This type of rehabilitation focuses on helping you:
14 Sources
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Johns Hopkins Medicine.Carotid artery stenosis.
Harskamp RE, Alexander JH, Ferguson TB, et al.Frequency and predictors of internal mammary artery graft failure and subsequent clinical outcomes: insights from the project of ex-vivo vein graft engineering via transfection (Prevent) iv trial.Circulation. 2016;133(2):131-138. doi:10.1161/CIRCULATIONAHA.115.015549
Mount Sinai.Coronary angiography.
Reser D, Caliskan E, Tolboom H, Guidotti A, Maisano F.Median sternotomy.Multimed Man Cardiothorac Surg. 2015;2015:mmv017. doi:10.1093/mmcts/mmv017
Waterman LA, DrBiolHum BHB, Gebara MA, et al.Bypassing the blues: insomnia in the depressed post-CABG population.Ann Clin Psychiatry. 2020;32(1):17-26
Centers for Disease Control and Prevention.How cardiac rehabilitation can help heal your heart.
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