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Coronary Bypass Surgery Tips

Open Heart Surgery - What All Should You Know

Dr. Amar Nath Shaw 90% (10 ratings)
MCh (CTVS)
Cardiothoracic Vascular Surgery, Patna
Open Heart Surgery - What All Should You Know

Open heart surgery is a complicated heart procedure. Howeevr, it is still an important surgical procedure to fix critical heart ailments.

Here is a quick fact-checker about this procedure:

  • The Coronary Artery Bypass Graft or CABG is one of the frequently performed procedures in the open-heart surgery space. This is a procedure that is related to fixing the blocked arteries of the heart. A study conducted by the National Institutes of Health revealed that most patients who had undergone CABG become angina-free within a span of five years.
  • Many hospitals refuse to share any data related to the surgery. It makes sense to run a background check on the surgeon who is scheduled to perform the procedure. Society of Thoracic Surgery lists all doctors and the number of procedures they have performed in this space.
  • This is one of the few surgeries where a doctor needs to make a deep incision close to 2-2.5 inch through the breastbone to separate muscle and get access to the heart.
  • The recent trend is that the doctor can achieve the same result with beating heart CABG where heart does not need to be stopped just to avoid the complications of heart lung machine Once the procedure is over, the doctor closes the incision made through the breastbone with sternal wires. Subsequently, the patient is taken off from the heart-lung machine.
  • The patient might find himself tangled with many tubes as he wakes for the first time after the surgery. These wires take the fluid out of the body. They serve as a temporary pacemaker for the patient.
  • It is important to get a clarification from the surgeon as to from which location of the body would the veins be taken from to perform CABG. Most doctors prefer the vein from the leg.
  • The patient is kept in an ICU for a couple of days before he is shifted to the general ward where he spends close to a couple of weeks before he is released. After the patient gets home, the typical recovery time for the patient is approximately 6-8 weeks.
  • One has to usually deal with heightened emotions after an open-heart surgery. 

Acute Coronary Syndrome - How To Manage It?

Dr. Deepesh Venkatraman 85% (10 ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, DNB-Cardialogist, DM - Cardiology
Cardiologist, Bangalore
Acute Coronary Syndrome - How To Manage It?

The word acute coronary syndrome refers to a group of symptoms that are caused by blockage of the blood flow to the heart muscles.  The most common result of this is myocardial infarction or heart attack as it is popularly called. Reduced blood flow leads to death of some portion of the heart muscle wall. While the word heart attack sounds almost fatal, it need not be the case. Knowing how to identify an attack and being aware of some simple measures can help save lives. 

Symptoms:  The tell-tale signs of a heart attack are as follows:
- Chest pain and discomfort usually described as a tightness or burning in the chest region
- Pain along the left side of the shoulder and neck, going up into the jaw, down to the arm
- Nausea and vomiting 
- Profuse sweating 
- Difficulty breathing 
- Dizzy or fuzzy feeling 
- Tired, extreme fatigue
- Anxious, apprehensive feeling 

However, be also aware that there are a lot of people who experience a silent heart attack. Women, obese, elderly, and diabetic patients can have silent attacks, and depending on severity, either they go on with life as usual or can have a fatal attack.

Diagnosis: Once you are doubtful of a heart attack, the next step is to reach the closest medical facility for a diagnosis.  In addition to a detailed examination and history, the following two tests will be performed.

- Electrocardiogram (ECG): A 12-lead ECG will measure electrical activity of the heart and identify irregular electrical activity which is indicative of a myocardial infarction.

- Blood tests:  Presence of certain enzymes in the blood, CK-MB and troponin, are indicative of a heart attack.  A complete electrolyte profile also will be done, and increase or decrease of some electrolytes is helpful in diagnosing a heart attack.

- In addition to these two, chest radiography, cardiac angiography, echocardiogram, stress test, and computed coronary tomography may also be required to confirm the diagnosis.


Management:  Once diagnosed, the first step would be to relieve the symptoms, negate the effects of reduced blood flow, and restore cardiac function. 

- Dissolve the clot - Using thrombolytics like clopedigrol 

- Nitroglycerin - To dilate the blood vessels and improve blood flow, especially to the heart muscles

- Anticoagulant therapy - Blood thinners are usually used to avoid blood clot formation; aspirin and heparin are the most commonly used agents.

- Blood pressure maintaining drugs like beta blockers and/or angiotensin-converting enzyme (ACE) inhibitors are also used

- Statins are used to reduce the amount of cholesterol in the blood and stabilize plaque deposits.
In very severe cases, angioplasty and stenting or coronary bypass surgery may be required.

Educating people on how to identify a heart attack and manage it is very useful and can help save lives.
 

2573 people found this helpful

Acute Coronary Syndrome - How To Diagnose It?

MBBS, DM - Cardiology, MD - Medicine
Cardiologist, Bhopal
Acute Coronary Syndrome - How To Diagnose It?

The word acute coronary syndrome refers to a group of symptoms that are caused by blockage of the blood flow to the heart muscles.  The most common result of this is myocardial infarction or heart attack as it is popularly called. Reduced blood flow leads to death of some portion of the heart muscle wall. While the word heart attack sounds almost fatal, it need not be the case. Knowing how to identify an attack and being aware of some simple measures can help save lives. 

Symptoms

The tell-tale signs of a heart attack are as follows:

  1. Chest pain and discomfort usually described as a tightness or burning in the chest region
  2. Pain along the left side of the shoulder and neck, going up into the jaw, down to the arm
  3. Nausea and vomiting 
  4. Profuse sweating 
  5. Difficulty breathing 
  6. Dizzy or fuzzy feeling 
  7. Tired, extreme fatigue
  8. Anxious, apprehensive feeling 

However, be also aware that there are a lot of people who experience a silent heart attack. Women, obese, elderly, and diabetic patients can have silent attacks, and depending on severity, either they go on with life as usual or can have a fatal attack.

Diagnosis

Once you are doubtful of a heart attack, the next step is to reach the closest medical facility for a diagnosis.  In addition to a detailed examination and history, the following tests will be performed.

  1. Electrocardiogram (ECG): A 12-lead ECG will measure electrical activity of the heart and identify irregular electrical activity which is indicative of a myocardial infarction.
  2. Blood tests:  Presence of certain enzymes in the blood, CK-MB and troponin, are indicative of a heart attack.  A complete electrolyte profile also will be done, and increase or decrease of some electrolytes is helpful in diagnosing a heart attack.
  3. In addition to these two, chest radiography, cardiac angiography, echocardiogram, stress test, and computed coronary tomography may also be required to confirm the diagnosis.

Management

Once diagnosed, the first step would be to relieve the symptoms, negate the effects of reduced blood flow, and restore cardiac function. 

  1. Dissolve the clot - Using thrombolytics like clopedigrol 
  2. Nitroglycerin - To dilate the blood vessels and improve blood flow, especially to the heart muscles
  3. Anticoagulant therapy - Blood thinners are usually used to avoid blood clot formation; aspirin and heparin are the most commonly used agents.
  4. Blood pressure maintaining drugs like beta blockers and/or angiotensin-converting enzyme (ACE) inhibitors are also used
  5. Statins are used to reduce the amount of cholesterol in the blood and stabilize plaque deposits.

In very severe cases, angioplasty and stenting or coronary bypass surgery may be required.

Educating people on how to identify a heart attack and manage it is very useful and can help save lives.
 

2785 people found this helpful

Heart Bypass Surgery Brings Long-Term Benefits!

Dr. Vivek Baliga B 92% (41 ratings)
MBBS, MRCP (UK), PG Diploma In Lipid Management, MBA (Healthcare)
Cardiologist, Bangalore
Heart Bypass Surgery Brings Long-Term Benefits!

Coronary Artery Bypass Grafting (CABG) is a traditional and well established surgical procedure for treating diseases in the coronary artery. The process is carried out by using blood vessels alternately (vein or artery). Initially, CABG was performed by using the left internal mammary artery and saphenous vein. It was observed that the chance of occlusion in the vein grafts was much higher than the arterial grafts. In the last decade, total arterial grafting, which uses all the arterial conduits, is being practiced as CABG for better results.

Types of Coronary Artery Bypass Grafting

  1. Traditional Coronary Artery Bypass Grafting: In this type of CABG, the surgeon will initially open up the chest bone to gain access to the heart. The heart is stopped using medications and the body is connected to a heart-lung bypass machine to circulate oxygen and blood throughout the body.
  2. Minimally invasive direct coronary artery bypass grafting: In this surgery, small incisions are made on the left portion of the chest to gain access to the heart. This surgery is used to bypass the blood vessels present in the front portion of the heart.
  3. Off-pump Coronary artery bypass grafting: In this procedure, the chest bone is opened up to access the heart. Here, however, the heart is not stopped during the surgery.

Patients, who have been suffering since a long time and have been operated on the vein grafts, have a chance of re-developing certain artery diseases such as a heart attack. To counter this possibility, surgeons have started using the method of Total Artery CABG. In this procedure, the left and right internal mammary arteries are used from the chest and the radial artery, from the fore arm for the surgery.

The main advantages of this procedure are:

  1. The survival rate is higher in total artery CABG as compared to the traditional CABG.
  2. It comes with long term benefits
  3. The procedure is safe as well as feasible


 

3384 people found this helpful

Coronary Artery Bypass Grafting (CABG) - The Many Benefits Of It!

Dr. Amar Nath Shaw 90% (10 ratings)
MCh (CTVS)
Cardiothoracic Vascular Surgery, Patna
Coronary Artery Bypass Grafting (CABG) - The Many Benefits Of It!

Coronary Artery Bypass Grafting (CABG) is a traditional and well established surgical procedure for treating diseases in the coronary artery. The process is carried out by using blood vessels alternately (vein or artery). Initially, CABG was performed by using the left internal mammary artery and saphenous vein. It was observed that the chance of occlusion in the vein grafts was much higher than the arterial grafts. In the last decade, total arterial grafting, which uses all the arterial conduits, is being practiced as CABG for better results.

Types of Coronary Artery Bypass Grafting

  1. Traditional Coronary Artery Bypass Grafting: In this type of CABG, the surgeon will initially open up the chest bone to gain access to the heart. The heart is stopped using medications and the body is connected to a heart-lung bypass machine to circulate oxygen and blood throughout the body.
  2. Minimally invasive direct coronary artery bypass grafting: In this surgery, small incisions are made on the left portion of the chest to gain access to the heart. This surgery is used to bypass the blood vessels present in the front portion of the heart.
  3. Off-pump Coronary artery bypass grafting: In this procedure, the chest bone is opened up to access the heart. Here, however, the heart is not stopped during the surgery.

Patients, who have been suffering since a long time and have been operated on the vein grafts, have a chance of re-developing certain artery diseases such as a heart attack. To counter this possibility, surgeons have started using the method of Total Artery CABG. In this procedure, the left and right internal mammary arteries are used from the chest and the radial artery, from the fore arm for the surgery.

The main advantages of this procedure are:

  1. The survival rate is higher in total artery CABG as compared to the traditional CABG.
  2. It comes with long term benefits
  3. The procedure is safe as well as feasible


 

5283 people found this helpful

Coronary Artery Bypass Grafting (CABG) - Know Its Type And Benefits!

MBBS, MD, DM, AFESC, FACC
Cardiologist, Guwahati
Coronary Artery Bypass Grafting (CABG) - Know Its Type And Benefits!

Coronary Artery Bypass Grafting (CABG) is a traditional and well established surgical procedure for treating diseases in the coronary artery. The process is carried out by using blood vessels alternately (vein or artery). Initially, CABG was performed by using the left internal mammary artery and saphenous vein. It was observed that the chance of occlusion in the vein grafts was much higher than the arterial grafts. In the last decade, total arterial grafting, which uses all the arterial conduits, is being practiced as CABG for better results.

Types of Coronary Artery Bypass Grafting

  1. Traditional Coronary Artery Bypass Grafting: In this type of CABG, the surgeon will initially open up the chest bone to gain access to the heart. The heart is stopped using medications and the body is connected to a heart-lung bypass machine to circulate oxygen and blood throughout the body.
  2. Minimally invasive direct coronary artery bypass grafting: In this surgery, small incisions are made on the left portion of the chest to gain access to the heart. This surgery is used to bypass the blood vessels present in the front portion of the heart.
  3. Off-pump Coronary artery bypass grafting: In this procedure, the chest bone is opened up to access the heart. Here, however, the heart is not stopped during the surgery.

Patients, who have been suffering since a long time and have been operated on the vein grafts, have a chance of re-developing certain artery diseases such as a heart attack. To counter this possibility, surgeons have started using the method of Total Artery CABG. In this procedure, the left and right internal mammary arteries are used from the chest and the radial artery, from the fore arm for the surgery.

The main advantages of this procedure are:

  1. The survival rate is higher in total artery CABG as compared to the traditional CABG.
  2. It comes with long term benefits
  3. The procedure is safe as well as feasible


 

1724 people found this helpful

Know The Benefits Of Coronary Artery Bypass Grafting (CABG)!

Dr. Abhishek Singh 93% (19 ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MD - Medicine, DNB - Cardiology
Cardiologist, Ghaziabad
Know The Benefits Of Coronary Artery Bypass Grafting (CABG)!

Coronary Artery Bypass Grafting (CABG) is a traditional and well established surgical procedure for treating diseases in the coronary artery. The process is carried out by using blood vessels alternately (vein or artery). Initially, CABG was performed by using the left internal mammary artery and saphenous vein. It was observed that the chance of occlusion in the vein grafts was much higher than the arterial grafts. In the last decade, total arterial grafting, which uses all the arterial conduits, is being practiced as CABG for better results.

Types of Coronary Artery Bypass Grafting

  1. Traditional Coronary Artery Bypass Grafting: In this type of CABG, the surgeon will initially open up the chest bone to gain access to the heart. The heart is stopped using medications and the body is connected to a heart-lung bypass machine to circulate oxygen and blood throughout the body.
  2. Minimally invasive direct coronary artery bypass grafting: In this surgery, small incisions are made on the left portion of the chest to gain access to the heart. This surgery is used to bypass the blood vessels present in the front portion of the heart.
  3. Off-pump Coronary artery bypass grafting: In this procedure, the chest bone is opened up to access the heart. Here, however, the heart is not stopped during the surgery.

Patients, who have been suffering since a long time and have been operated on the vein grafts, have a chance of re-developing certain artery diseases such as a heart attack. To counter this possibility, surgeons have started using the method of Total Artery CABG. In this procedure, the left and right internal mammary arteries are used from the chest and the radial artery, from the fore arm for the surgery.

The main advantages of this procedure are:

  1. The survival rate is higher in total artery CABG as compared to the traditional CABG.
  2. It comes with long term benefits
  3. The procedure is safe as well as feasible


 

2334 people found this helpful

Coronary Artery Bypass Grafting (CABG) - The Many Benefits Of It!

DM - Cardiology -, MD - General Medicine - , MBBS, FSCAI, MHRS, FACC, FESC , Fellowship in Interventional Cardiology & EP, Interventional Cardiology & EP and Devices, Senior Specialist( Interventional Cardiology), Fellow of southeast Asian Interventional Cardiology Society, International Award of Excellence in Cardiology
Cardiologist, Delhi
Coronary Artery Bypass Grafting (CABG) - The Many Benefits Of It!

Coronary Artery Bypass Grafting (CABG) is a traditional and well established surgical procedure for treating diseases in the coronary artery. The process is carried out by using blood vessels alternately (vein or artery). Initially, CABG was performed by using the left internal mammary artery and saphenous vein. It was observed that the chance of occlusion in the vein grafts was much higher than the arterial grafts. In the last decade, total arterial grafting, which uses all the arterial conduits, is being practiced as CABG for better results.

Types of Coronary Artery Bypass Grafting

  1. Traditional Coronary Artery Bypass Grafting: In this type of CABG, the surgeon will initially open up the chest bone to gain access to the heart. The heart is stopped using medications and the body is connected to a heart-lung bypass machine to circulate oxygen and blood throughout the body.
  2. Minimally invasive direct coronary artery bypass grafting: In this surgery, small incisions are made on the left portion of the chest to gain access to the heart. This surgery is used to bypass the blood vessels present in the front portion of the heart.
  3. Off-pump Coronary artery bypass grafting: In this procedure, the chest bone is opened up to access the heart. Here, however, the heart is not stopped during the surgery.

Patients, who have been suffering since a long time and have been operated on the vein grafts, have a chance of re-developing certain artery diseases such as a heart attack. To counter this possibility, surgeons have started using the method of Total Artery CABG. In this procedure, the left and right internal mammary arteries are used from the chest and the radial artery, from the fore arm for the surgery.

The main advantages of this procedure are:

  1. The survival rate is higher in total artery CABG as compared to the traditional CABG.
  2. It comes with long term benefits
  3. The procedure is safe as well as feasible


 

1 person found this helpful

What are The Benefits Of Coronary Artery Bypass Grafting (CABG)?

DNB (Cardiology), DNB (General Medicine), MBBS
Cardiologist, Pune
What are The Benefits Of Coronary Artery Bypass Grafting (CABG)?

Coronary Artery Bypass Grafting (CABG) is a traditional and well established surgical procedure for treating diseases in the coronary artery. The process is carried out by using blood vessels alternately (vein or artery). Initially, CABG was performed by using the left internal mammary artery and saphenous vein. It was observed that the chance of occlusion in the vein grafts was much higher than the arterial grafts. In the last decade, total arterial grafting, which uses all the arterial conduits, is being practiced as CABG for better results.

Types of Coronary Artery Bypass Grafting

  1. Traditional Coronary Artery Bypass Grafting: In this type of CABG, the surgeon will initially open up the chest bone to gain access to the heart. The heart is stopped using medications and the body is connected to a heart-lung bypass machine to circulate oxygen and blood throughout the body.
  2. Minimally invasive direct coronary artery bypass grafting: In this surgery, small incisions are made on the left portion of the chest to gain access to the heart. This surgery is used to bypass the blood vessels present in the front portion of the heart.
  3. Off-pump Coronary artery bypass grafting: In this procedure, the chest bone is opened up to access the heart. Here, however, the heart is not stopped during the surgery.

Patients, who have been suffering since a long time and have been operated on the vein grafts, have a chance of re-developing certain artery diseases such as a heart attack. To counter this possibility, surgeons have started using the method of Total Artery CABG. In this procedure, the left and right internal mammary arteries are used from the chest and the radial artery, from the fore arm for the surgery.

The main advantages of this procedure are:

  1. The survival rate is higher in total artery CABG as compared to the traditional CABG.
  2. It comes with long term benefits
  3. The procedure is safe as well as feasible


 

2147 people found this helpful

Open Heart Surgery - Things You Must Know About It!

MCH DNB (CTVS), Advanced fellowship, MS
Cardiologist, Delhi
Open Heart Surgery - Things You Must Know About It!

Open heart surgery is a complicated heart procedure. Although the number of open heart surgeries performed over the past has decade has reduced significantly, howeevr, it is still an important surgical procedure to fix critical heart ailments.

Here is a quick fact-checker about this procedure:

  • The Coronary Artery Bypass Graft or CABG is one of the frequently performed procedures in the open-heart surgery space. This is a procedure that is related to fixing the blocked arteries of the heart. A study conducted by the National Institutes of Health revealed that most patients who had undergone CABG become angina-free within a span of five years.
  • Many hospitals refuse to share any data related to the surgery. It makes sense to run a background check on the surgeon who is scheduled to perform the procedure. Society of Thoracic Surgery lists all doctors and the number of procedures they have performed in this space.
  • This is one of the few surgeries where a doctor needs to make a deep incision close to 2-2.5 inch through the breastbone to separate muscle and get access to the heart.
  • The patient is hooked to a heart-lung machine before the proceedings begin. This machine pushes blood to the body. It helps the doctor to stop the heart and perform the procedure. Once the procedure is over, the doctor closes the incision made through the breastbone with sternal wires. Then the surgeon gives a minor electric shock to the patient to restart the heart. Subsequently, the patient is taken off from the heart-lung machine.
  • The patient might find himself tangled with many tubes as he wakes for the first time after the surgery. These wires take the fluid out of the body. They serve as a temporary pacemaker for the patient.
  • It is important to get a clarification from the surgeon as to from which location of the body would the veins be taken from to perform CABG. Most doctors prefer the vein from the leg. However, recent studies have shown that veins can be extracted from the internal chest wall. This results in a speedy recovery for the patient.
  • The patient is kept in an ICU for a couple of days before he is shifted to the general ward where he spends close to a couple of weeks before he is released. After the patient gets home, the typical recovery time for the patient is approximately 6-8 weeks.
  • One has to usually deal with heightened emotions after an open-heart surgery. Studies have shown that over 20 percent of the CABG patients suffer from depression, anger, and other emotional problems. This typically lasts for a year till everything becomes normal.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2450 people found this helpful
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