Coronary Artery Bypass Surgery
WHAT IS IT?
This surgery is also called a “CABG,” which stands for coronary artery bypass graft. In a coronary artery bypass, the surgeon opens the chest, often called “open heart surgery,” to expose the blood vessels serving the heart. The surgeon cuts out the area of blockage from one or more coronary arteries, and replaces the damaged section of arteries with a “bypass” graft using veins from other parts of the body, such as the leg. The graft is sewn into the main coronary arteries and restores healthy blood flow and oxygen delivery to the heart muscle, allowing normal function.
ARE YOU A CANDIDATE?
CABG procedures are one of several options to open the coronary arteries and restore blood flow. Others include angioplasty and stents. During your consultation with our cardiovascular surgeons, your physician will discuss the procedure that is best for your situation and medical needs.
CABG surgery is needed when the large coronary arteries that provide oxygen-carrying blood supply to the heart muscle are blocked, usually due to cholesterol-containing plaque buildup. The blockage reduces blood flow and oxygen delivery to the heart muscle so the muscle cannot function to pump blood to the rest of the body.
CABG surgery is typically recommended when more conservative measures, such as medications, stents, or angioplasty, have not provided relief of chest pain. The surgery doesn’t cure the underlying disease – atherosclerosis – that caused the blockage, but it does relieve the mechanical obstruction preventing optimal blood flow. Then after surgery, your physician will recommend diet, exercise, and medications to help prevent recurrence of the blockage.
Loss of blood flow and oxygen is a cause of chest pain (angina) and heart attacks (myocardial infarction). If the blockage is severe enough, the loss of oxygen causes death of the heart muscle (infarction). If the area of damage to the heart muscle is large enough, it can cause death.
Patients who need bypass surgery typically have symptoms of severe chest pain with radiation into the neck and left arm, associated with shortness of breath. They may also experience pain in the legs with exercise due to diminished blood flow and oxygen delivery to the rest of the body. If symptoms occur even with light exercise or at rest, it indicates greater degree of blockage that could lead to a massive heart attack and death.
HOW IS THE SURGERY DONE?
CABG procedure is a major surgery performed under general anesthesia. Traditionally it involved a long incision through the sternum (breastbone) to reach the chest cavity containing the heart. Newer, minimally invasive techniques, often using laparoscopy or the Da Vinci robotic system, require smaller incisions and thus allow speedier recovery.
There are two different options in use today: “on-pump” CABG in which the heart is temporarily stopped and blood is diverted through a heart-lung machine; and “off-pump” CABG in which the heart is still beating and the surgeon is able to use special equipment to keep the beating heart steady in the area for the bypass to be done. Then a healthy blood vessel (“graft”) is taken from the leg or arm or other site and the surgeon sews this into the area of the artery from which the blockage was removed, and this allows normal blood flow again. Depending on how many coronary arteries need to have a graft, the surgery can take between 3 to 6 or more hours.
WHAT BENEFITS CAN I EXPECT?
The most important benefit is relief of chest pain, and improved ability to carry out your daily activities without pain or shortness of breath. Better quality of life and reduced risk of dying of a massive, sudden heart attack are the other key benefits of surgery. To reduce the risk of recurrence of blockages in the repaired blood vessels, your physician will recommend diet, exercise, medication, smoking cessation, and stress management techniques. We typically recommend a supervised Cardiac Rehabilitation exercise program for the first few months after surgery until your heart muscle has become stronger and your exercise tolerance has improved.
WHAT ARE THE POSSIBLE RISKS?
Any major surgery has potential general risks that we do our best to minimize by carefully evaluating all our patients with medical and surgical review and consultation before you ever leave home to do our best to be sure that:
- you meet the appropriate criteria for the procedure,
- you are medically stable to travel and undergo surgery,
- you are mentally prepared and feel comfortable with your surgeon,
- your surgeon has the right training and experience to meet your needs,
- the hospital has all the facilities and equipment to properly carry out the surgery recommended.
Med Expert Chile has selected the leading surgeons in their fields and one of the top private hospitals in Santiago known for its meticulous attention to reducing risks of infection and complications during surgeries. With over 25,000 surgeries in 2013, our partner hospital had a 0.8% infection rate, one of the lowest in the world.
General risks of any major surgery can include, but are not limited to, infection, excessive bleeding or blood clots, adverse reactions to anesthesia, damage to other tissues surrounding the surgical site, or in very rare cases, disability or death. Specific risks known to occur with your particular procedure will be discussed ahead of time by your surgeon.
We do everything possible to reduce these risks and help you feel comfortable and prepared to go forward with surgery.
WHAT DOES IT COST?
We do not sell “Off-the-shelf” surgeries at a fixed cost. We determine the right procedure for you after your medical-surgical consultation to discuss your best options. A precise cost estimate can only be given after our Medical Director and Surgeons have completely evaluated your specific case and your medical needs.