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Coronary Artery Bypass Graft (CABG) Surgery in India

 

Coronary Artery Bypass Graft

Heart Failure Surgery India, Low Cost Heart Failure Treatment India, Heart Failure Surgery Treatment Advantages IndiaCoronary artery bypass graft surgery (CABG) is a procedure that is used to treat coronary artery disease.  Coronary artery disease (CAD) is the narrowing of the coronary arteries (the blood vessels that supply oxygen and nutrients to the heart muscle), caused by a buildup of fatty material within the walls of the arteries. This buildup causes the inside of the arteries to become rough and narrowed, limiting the supply of oxygen-rich blood to the heart muscle. Coronary artery bypass graft surgery is designed to detour blood around a narrowed segment of a heart artery in an effort to restore blood flow to the heart muscle.  Usually a vein graft from the leg is used for the bypass however other vessels may be used for the graft. The surgery can eliminate chest pain, improve exercise capability and lengthen life.


Symptoms of Coronary Artery Diseases

Symptoms of coronary artery disease may include the following:

  • chest pain

  • fatigue

  • palpitations

  • shortness of breath

Unfortunately, there may be no symptoms of early coronary artery disease, yet the disease will continue to progress until sufficient artery blockage exists to cause symptoms and problems.


Causes of Coronary Artery Diseases

  • Major reason or causes for coronary artery disease are smoking, high blood pressure (hypertension), large amounts of fatty substances in the blood (hypercholesterolemia and hypertriglyceridemia), lack of exercise, diabetes, and positive family history of coronary artery disease.

  • Other relative causes include obesity (more than 20% of ideal body weight), and tension or stress.


Diagnosis and Tests of Coronary Artery Diseases

Your doctor will diagnose coronary heart disease (CHD) based on your medical and family histories, your risk factors for CHD, a physical exam, and the results from tests and procedures. He or she may suggest one or more diagnostic tests as well, including:

  • Blood tests: to confirm presence of special enzymes released by the damaged heart muscle 

  • Chest X-ray 

  • Electrocardiogram (EKG)

  • Exercise stress test with or without injection of a radioisotope called thallium

  • If any of the above tests are positive for coronary artery disease, cardiac catheterization may be performed to demonstrate the site and severity of the coronary artery narrowing.

  • Following cardiac catheterization the doctor may recommend coronary artery bypass surgery.


Types of Coronary Artery Bypass Grafting Surgery

There are two types of Coronary Artery Bypass Grafting operations currently available: 

  • On-Pump Surgery: On-pump procedures require the surgeon to open the chest bone (sternum), stop the patient's heart, and place the patient on a heart-lung machine. This machine takes over the function of the patient's heart—delivering oxygenated blood through out the body and brain—while the bypass is performed.

  • Off-Pump Surgery: A new, minimal access procedure, the off-pump method eliminates the need for the surgeon to stop the heart and to place the patient on bypass. The surgeon operates directly on the beating heart, reducing the risk for preoperative bleeding and stroke associated with the on-pump procedure. Selection of an on- versus off-pump procedure partly depends on the health of the individual patient.


Preparations for Coronary Artery Bypass Graft (CABG) Surgery

  • The physician will have a detailed discussion of the procedure with the patient.

  • The physician may enquire about the complete medical history of the patient; he may also perform a complete physical examination, blood tests or other diagnostic tests to ensure you are in good health before undergoing the procedure.

  • The patient may not be allowed to eat 8-10hrs before the procedure.

  • The patient should notify the physician of any history of bleeding disorders or if he is taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary to stop some of these medications prior to the procedure. 

  • The patient should stop smoking as soon as possible prior to the procedure. This may improve his chances for a successful recovery from surgery and benefit his overall health status.


Coronary Artery Bypass Graft Surgery Procedures

  • On-Pump Surgery Procedure

Tubes will be inserted into the heart so that the blood can be pumped through your body by a cardiopulmonary bypass machine as the heart must be stopped to allow the physician to perform the procedure of sewing grafts onto the very small coronary arteries. 

When the heart has been stopped, the physician will perform the bypass graft procedure by sewing one end of a section of vein over a tiny opening made in the coronary artery just above the blockage, and the other end over a tiny opening made in the coronary artery just below the blockage.

If the internal mammary artery inside your chest is being used as a bypass graft, the lower end of the artery will be cut from inside the chest and sewn over an opening made in the coronary artery below the blockage. 

Once the bypass grafts have been completed, the blood circulating through the bypass machine will be allowed back into your heart and the tubes to the machine will be removed. The heart will be restarted. 

Temporary wires for pacing may be inserted into the heart. These wires can be attached to a pacemaker and the heart can be paced, if needed, during the initial recovery period.

The sternum will be pushed back together and sewn together with small wires. The skin over the sternum will be sewn back together. Tubes will be inserted into your chest to drain blood and other fluids from around the heart. These tubes will be connected to a suction device to keep fluids pulled away from the heart.  A tube will be inserted through your mouth or nose into your stomach to drain stomach fluids. 

  • Off-Pump Surgery Procedure

Once the chest has been opened, the area around the artery to be bypassed will be stabilized with a special type of instrument. The rest of the heart will continue to function and pump blood through the body. 

The physician will perform the bypass graft procedure by sewing one end of a section of vein over a tiny opening made in the coronary artery just above the blockage, and the other end over a tiny opening made in the coronary artery just below the blockage.  Before the chest is closed, the physician will examine the grafts to make sure they are working.

The sternum will be pushed back together and sewn together with small wires. The skin over the sternum will be sewn back together. Tubes will be inserted into your chest to drain blood and other fluids from around the heart. These tubes will be connected to a suction device to keep fluids pulled away from the heart.  A tube will be inserted through your mouth or nose into your stomach to drain stomach fluids. 


Follow- Up Care Post Coronary Artery Bypass Graft Surgery

  • The average hospital stay is 4-6 days

  • Deep breathing exercises and coughing are encouraged to help speed recovery. Coughing reduces the chance of pneumonia and fever and will not disturb the incision

  • It is wise to reduce coronary risk factors as much as possible by reducing dietary intake of salt, cholesterol and saturated fats

  • It is important to maintain an appropriate weight and avoid smoking

  • Weakness is a common feeling on returning home due to lack of use of big muscles. Exercise, such as walking, is a good way to regain muscle strength

  • Sedentary workers may have to wait four to six weeks before returning to work

  • The physician will give you specific bathing instructions before discharging the patient. The sutures or surgical staples will be removed during a follow-up office visit.

  • The patient should notify his physician of any redness, swelling, or bleeding or other drainage from the incision site, increase in pain around the incision site, fever and/or chills, etc.


Advantages of Coronary Artery Bypass Grafting (CABG) Surgery

  • Although traditional Coronary Bypass Grafting Surgery is performed with a 2-3% mortality and average hospital length of stay of less than 7 days, retrospective studies suggest that off-pump CABG may be safer, with fewer procedure-related deaths and complications. OPCABG is associated with fewer blood transfusions, decreased ventilator dependence, less renal insufficiency, and fewer strokes.

  • Other advantages/benefits of Coronary artery bypass grafting surgery are reduced pain following bypass surgery, less time in the hospital recovering, usually no need for a blood transfusion, reduced risk of complications, fewer infections and quicker recovery.

  • For minimally invasive procedures done without putting the patient on a heart-lung machine, there are additional potential benefits, since being on this machine may increase the risk of kidney problems, difficulties with memory, and the need for transfusion.


Risks Associated with Coronary Artery Bypass Grafting (CAGB) Surgery

One possible complication is atrial fibrillation, or irregular heartbeats, which occur in about 25% of all heart surgery patients. Typically not dangerous, this condition typically happens in older patients. Other complications include fevers, pain, and drainage from your wounds


Coronary Artery Bypass Graft (CAGB) Surgery in India

In India, most hospitals have a team of dedicated healthcare professionals who have international recognition in the field of research, diagnosis and treatment of coronary artery bypass graft. These hospitals offer a “cutting-edge" treatment for different cardiac disorders and make management decisions based on opinions informed by the latest scientific data. Most hospitals in India have plenty of heart and vascular specialists who are widely known for their surgical skills. Cases that appear to benefit from coronary bypass include patients who have symptomatic heart disease in multiple coronary arteries, and those who have suffered a prior or acute myocardial infarction.

Cities in India offering Coronary Artery Bypass Graft Surgery at some of the best and top cardiac hospitals are as follows;



Cost of Coronary Artery Bypass Graft (CABG) Surgery in India

India is the most cost effective medical tourism destination of the world. The cost of coronary artery bypass graft surgery in India is very low as compared to the cost of the similar procedure charged in other western countries. This applies to treatment and surgeries associated with coronary artery bypass graft surgery. Even after adding travel and accommodation costs, treatment of coronary artery bypass graft surgery in India can result in up to 50 to 80% cost savings.All surgery and treatments are tailored to consider the needs of the travelling patient. India  gives you the opportunity to have high class immediate surgical and medical treatments which includes coronary artery bypass graft surgery at low cost.

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