Coronary Artery Bypass Grafting, CABG, is done to improve circulation to the heart muscle in people with coronary artery disease or severe coronary artery disease. During this procedure, a healthy artery or vein from another part of the body is connected or grafted to the blocked coronary artery. The artery or vein graft performed bypasses the blockage by serving as a bridge which transports oxygenated blood to the heart muscle. During the procedure one or more coronary arteries can be connected.
Before surgery, an intravenous line IV will be inserted and you may be given medicine to help you relax.CABG procedures are performed under general anesthesia, which will sedate the patient during the operation. A breathing tube will be inserted through your mouth and throat to help you breathe during the procedure. A catheter will be placed in your bladder to drain urine. Coronary artery bypass surgery generally takes three to six hours. During a conventional CABG, the surgeon begins by making an incision in the skin over your breastbone, or sternum. After that they will separate the breastbone and move your rib cage to expose your heart. Throughout the procedure, your circulatory system will be connected to a cardiopulmonary bypass pump or heart-lung machine. This machine temporarily takes over the functions of the heart and lungs during surgery, allowing the heart to stop while the surgeon stitches the grafts in place. One of the two blood vessels that is typically used for grafts is the Internal Thoracic Artery in the chest or the Saphenous Vein in the leg. For the Internal Thoracic Artery graft, the surgeon will leave the upper end attached to the Subclavian Artery and bypass the lower end of the chest wall to the coronary artery just beyond the blockage, then the surgeon will sew the graft in place. For the Saphenous Vein Graft, the surgeon will suture one end to the aorta and the other end to the narrowed artery just past the blockage. With the graft securely in place, the surgeon will use electrical signals to restore the heartbeat and connect a temporary pacemaker to the heart. Once the heart returns to a normal beat, the heart-lung bypass machine will be turned off and the surgeon will reattach the breastbone and suture the skin. Once the incision has been closed, a temporary drainage tube will be placed through the skin below the incision.
It is important to note that two other types of off-pump procedures and minimally invasive bypass surgery have recently been developed. In the Off-pump CABG or “beating heart” bypass procedure the heart does not stop and a cardiopulmonary bypass machine is not used, instead a mechanical device called the heart stabilizer is used to stabilize the part of the heart being grafted. The surgeon will perform minimally invasive bypass procedures using instruments inserted through small incisions or ports in the chest; these procedures sometimes require a cardiopulmonary bypass machine. After surgery, the patient will be taken to the intensive care unit, his heart activity will be monitored and, if necessary, stimulation pods will be used to temporarily control his heart rate. The chest tube will remain in place to drain excess blood and air from the chest cavity. Once the patient is able to breathe on their own, the breathing tube will be removed and replaced with an oxygen mask. The catheter in your bladder will remain in place during your recovery for the next three to four days and when will be removed gradually.
#Education #Bypass #Surgery
2 ноя 2022
