Coronary arteries are blood vessels that supply oxygen rich pure blood to all parts of the heart muscle. There are two coronary arteries – right coronary artery and left coronary artery.
Coronary artery disease is the blockage of the arteries. This occurs when plaque has built up in the walls. This disease can be deadly.
Heart disease is the number one killer of men and women in America every year. Athersclerotic Coronary Artery Disease (ASCHD) is a term further defining heart disease. “Atherosclerotic” means hardening, or narrowing of the artery. Coronary arteries are the arteries that supply the heart muscle with blood. The entire body is supplied with blood and oxygen by the pumping power of the heart; therefore the heart is a very busy pump that requires a good steady flow of nutrient rich blood itself to function properly. When that blood supply is compromised, not only is the heart in trouble, but the whole body can fail.
Coronary artery bypass graft surgery (also called coronary artery bypass surgery [CABG] and bypass operation) is performed to restore blood flow to the heart. This relieves chest pain and ischemia, improves the patient’s quality of life.
It’s a surgery that they take veins from the legs and graft them to the heart.
Coronary artery bypass graft surgery is major surgery and patients may experience any of the complications associated with major surgery. The risk of death during coronary artery bypass graft surgery is two to three percent. Possible complications include graft closure and development of blockages in other arteries, long-term development of atherosclerotic disease of saphenous vein grafts, abnormal heart rhythms, high or low blood pressure, blood clots that can lead to a stroke or heart attack, infections, and depression. There is a higher risk for complications in patients who are heavy smokers, patients who have serious lung, kidney, or metabolic problems, or patients who have a reduced supply of blood to the brain. A 2003 report also described poverty as a risk factor for complications and death following coronary artery bypass surgery. It is likely that being poor is associated with a greater degree of stress, social isolation, and inadequate access to quick or preventive treatment.
Overall mortality related to CABG is 3-4%. During and shortly after CABG surgery, heart attacks occur in 5 to 10% of patients and are the main cause of death. About 5% of patients require exploration because of bleeding. This second surgery increases the risk of chest infection and lung complications. Stroke occurs in 1-2%, primarily in elderly patients. Mortality and complications increase with:
Mortality may be higher in women, primarily due to their advanced age at the time of CABG surgery and smaller coronary arteries. Women develop coronary artery disease about 10 years later than men because of hormonal “protection” while they still regularly menstruate (although in women with risk factors for coronary artery disease, especially smoking, elevated lipids, and diabetes, the possibility for the development of coronary artery disease at a young age is very real). Women are generally of smaller stature than men, with smaller coronary arteries. These small arteries make CABG surgery technically more difficult and prolonged. The smaller vessels also decrease both short and long-term graft function.
Generally, most patients can leave the hospital 7-9 days following coronary artery bypass graft surgery. It is important to have family members or friends available to assist you in your first week at home. Some hospitals arrange a home nursing assessment the day after your discharge. Additional services are available through home care agencies for patients who meet certain criteria for physical therapy, occupational therapy, and the services of a home health aide, or social worker.
That’s basically surgeries where they cut as little as possible. Instead of cutting someone wide open, surgeons go in through tiny holes with cameras and instruments on ends of slender tubes for instance.
Hensley, Frederick A., Donald E. Martin, and Glenn P. Gravlee, eds. A Practical Approach to Cardiac Anesthesia. 3rd ed. Philadelphia: Lippincott Williams and Wilkins 2003.
Rib fracture is the most common adverse event. Pericarditis also is a possible complication. Supraventricular arrhythmias and ST segment elevation also may develop.
An electrocardiogram detects the presence of acute coronary blockage (occlusion). A history of myocardial infarction can also be detected by electrocardiogram. Patients with a history of angina also are evaluated for coronary artery disease.
This approach provides patients some benefit in that cardiopulmonary bypass (use of a heart-lung machine) may be avoided, and smaller incisions can be used.
Patency (openness) of the grafted vessels is expected to be the same as what is seen in traditional coronary artery bypass grafting.
Minimally invasive valve surgery has been an outgrowth of the success with minimally invasive coronary artery bypass grafting.
