Minimally Invasive Multivessel CABG

This is a video showing Coronary Artery Bypass Grafting being done through left 4th intercostal space by a 6-7cm incision.

We are routinely doing Coronary Artery Bypass Grafting, single vessel or multivessel through left 4th or 5th Intercostal Space depending on position of apex of heart and the target arteries on routine chest x-ray and coronary angiogram. We are using skeletonised LIMA and Free Radial Artery to construct a ‘Y’ and then pick all the vessels to be grafted sequentially. Single Lung ventilation using an endobronchial tube is essential.

Team Includes Dr.Kshitij Dubey (Chief Cardiac Surgeon), Dr. Vikas Gupta (Chief Cardiac Anaesthetist), Dr. Krishnpal Singh (Anaesthetist) Mr.M.V.Krishna Mohan (Sr.Clinical Perfusionist), Rajshree Hospital & Research Centre, Indore, Madhya Pradesh.

 

Coronary Artery Bypass Graft (CABG off-pump)

heart with coronary arteries

heart with coronary arteries (Photo credit: Wikipedia)

Before we talk about treatment, let’s start with a discussion about the human body and about your medical condition.

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.