Tag Archives: Coronary artery bypass grafting

Coronary Artery Bypass (CABG) Surgery

Posted on by MaryO
Three coronary artery bypass grafts, a LIMA to...

Three coronary artery bypass grafts, a LIMA to LAD and two saphenous vein grafts – one to the right coronary artery (RCA) system and one to the obtuse marginal (OM) system. (Photo credit: Wikipedia)

Your doctor has recommended that you have coronary artery bypass surgery. But what does that actually mean?

Your heart is located in the center of your chest. It is surrounded by your rib cage and protected by your breastbone. Your heart’s job is to keep blood continually circulating throughout your body.
The vessels that supply the body with oxygen-rich blood are called arteries.

The vessels that return blood to the heart are called veins.
Like any other muscle in the body, the heart depends on a steady supply of oxygen rich blood. The arteries that carry this blood supply to the heart muscle are called coronary arteries.

Sometimes, these blood vessels can narrow or become blocked by deposits of fat, cholesterol and other substances collectively known as plaque.
Over time, plaque deposits can narrow the vessels so much that normal blood flow is restricted. In some cases, the coronary artery becomes so narrow that the heart muscle itself is in danger.

Coronary bypass surgery attempts to correct this serious problem. In order to restore normal blood flow, the surgeon removes a portion of a blood vessel from the patient’s leg or chest, most probably the left internal mammary artery and the saphenous vein.

Your doctor uses one or both of these vessels to bypass the old, diseased coronary artery and to build a new pathway for blood to reach the heart muscle. These transplanted vessels are called grafts and depending on your condition, your doctor may need to perform more than one coronary artery bypass graft.

Of course, operating on the heart is a complex and delicate process and in the case of bypass surgery, your doctor will most likely need to stop your heart before installing the graft.

During the time that your heart is not beating, a special machine, called a heart-lung machine, will take over the job of circulating and oxygenating your blood.

By using this machine, your doctor is able to repair the heart without interfering with the blood flow to the rest of the body.

Following surgery, your heart will be restarted and you will be disconnected from the heart-lung machine

More on CABG (Coronary Artery Bypass Grafting)

Posted on by MaryO

From the NIH: What To Expect After Coronary Artery Bypass Grafting

Checkmark
What DH had

Recovery in the Hospital

CheckmarkAfter surgery, you’ll typically spend 1 or 2 days in an intensive care unit (ICU). Your health care team will check your heart rate, blood pressure, and oxygen levels regularly during this time.

CheckmarkAn intravenous (IV) line will likely be inserted into a vein in your arm. Through the IV line, you may get medicines to control blood flow and blood pressure. You also will likely have a tube in your bladder to drain urine and a tube in your chest to drain fluid.

CheckmarkYou may receive oxygen therapy (oxygen given through nasal prongs or a mask) and a temporary pacemaker while in the ICU. A pacemaker is a small device that’s placed in the chest or abdomen to help control abnormal heart rhythms.

CheckmarkYour doctor also might recommend that you wear compression stockings on your legs. These stockings are tight at the ankle and become looser as they go up the legs. This creates gentle pressure that keeps blood from pooling and clotting.

CheckmarkWhile in the ICU, you’ll also have bandages on your chest incision (cut) and on the areas where arteries or veins were removed for grafting.

After you leave the ICU, you’ll be moved to a less intensive care area of the hospital for 3–5 days before going home. (only 2!)

Recovery at Home

Your doctor will give you instructions for recovering at home (yes to all), such as:

  • How to care for your healing incisions
  • How to recognize signs of infection or other complications
  • When to call the doctor right away
  • When to make followup appointments

You’ll also learn how to deal with common side effects from surgery. Side effects often go away within 4–6 weeks after surgery, but may include:

  • Discomfort or itching from healing incisions
  • Swelling of the area where arteries or veins were removed for grafting
  • Muscle pain or tightness in the shoulders and upper back
  • Fatigue (tiredness), mood swings, or depression
  • Problems sleeping or loss of appetite
  • Constipation
  • Chest pain at the site of the chest bone incision (more frequent with traditional CABG)

Full recovery from traditional CABG may take 6–12 weeks or more. Nontraditional CABG doesn’t require as much recovery time.

Your doctor will tell you when you can become active again. It varies from person to person, but there are some typical timeframes.

Often, people can resume sexual activity and return to work after about 6 weeks. Some people may need to find less physically demanding types of work or work a reduced schedule at first.

Talk with your doctor about when you can resume activity, including sexual activity, working, and driving.

Ongoing Care

Care after surgery may include periodic checkups with doctors. During these visits, you may have tests to see how your heart is working. Tests may include an EKG (electrocardiogram), stress testing, echocardiography, and a cardiac CT scan.

CABG is not a cure for coronary heart disease (CHD). After the surgery, your doctor may recommend a treatment plan that includes lifestyle changes. Following the plan can help you stay healthy and lower the risk of CHD getting worse.

Lifestyle changes might include changing your diet, quitting smoking, being physically active, losing weight or maintaining a healthy weight, and reducing stress.

For more information about lifestyle changes, go to the National Heart, Lung, and Blood Institute’s “Your Guide to Living Well With Heart Disease.”

Your doctor also may refer you to cardiac rehabilitation (rehab). Cardiac rehab is a medically supervised program that helps improve the health and well-being of people who have heart problems.

Cardiac rehab includes exercise training, education on heart healthy living, and counseling to reduce stress and help you return to an active life. Your doctor can tell you where to find a cardiac rehab program near your home.

Taking medicines as prescribed also is important after CABG. Your doctor may prescribe medicines to manage pain during recovery, lower your cholesterol and blood pressure, reduce the risk of blood clots forming, manage diabetes, or treat depression.

Two Weeks After CABG

Posted on by MaryO

Sounds like a fairy tale of some kind involving veggies like cabbage, lettuce and other greenery.  But it’s not.  CABG is the abbreviation for Coronary artery bypass grafting, something I had no idea about 2 weeks ago.

CABG

DH had 3 of those grafts, the mammary artery and 2 from his leg vein.

From NIH:

Coronary artery bypass grafting (CABG) is a type of surgery that improves blood flow to the heart. Surgeons use CABG to treat people who have severe coronary heart disease (CHD).

CHD is a disease in which a waxy substance called plaque (plak) builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart.

Over time, plaque can harden or rupture (break open). Hardened plaque narrows the coronary arteries and reduces the flow of oxygen-rich blood to the heart. This can cause chest pain or discomfort called angina< (an-JI-nuh or AN-juh-nuh).

If the plaque ruptures, a blood clot can form on its surface. A large blood clot can mostly or completely block blood flow through a coronary artery. This is the most common cause of a heart attack. Over time, ruptured plaque also hardens and narrows the coronary arteries.

CABG is one treatment for CHD. During CABG, a healthy artery or vein from the body is connected, or grafted, to the blocked coronary artery. The grafted artery or vein bypasses (that is, goes around) the blocked portion of the coronary artery. This creates a new path for oxygen-rich blood to flow to the heart muscle.

Surgeons can bypass multiple coronary arteries during one surgery.

I have to say it’s amazing how quickly the body can begin to heal after such an assault.  So far, we’ve seen the surgeon’s nurse practitioner and the visiting nurse.  Both say he’s doing very well for such a short amount of time.

There’s still some pain, some coughing, and other inconveniences but it’s amazing what modern medicine can do!