Congestive Heart Failure: What is Coronary Artery Bypass Surgery (CABG)?

Congestive Heart Failure is the leading cause of emergency hospitalization among people aged over sixty. It is a condition where the heart is inefficient in pumping the required amount of blood to the other parts of the body. This inefficiency can sometimes be so severe that it can impair the pumping action of the heart, causing congestive heart failure. This disease affects roughly 6 million people in the United States.

The mechanism behind congestive heart failure suggests that it doesn't necessarily mean that the heart has stopped working. It just indicates that the pumping efficiency of the heart has deteriorated. As the blood moves through the heart and body at a slower rate during heart failure, there is a sudden increase in the pressure inside the heart. This leads to impaired heart function with less oxygen being pumped through the heart, and less oxygen reaches the body. The chambers of the heart respond to the situation by either stretching to hold more blood or becoming thick and stiff. This weakens the muscles of the heart and leads to inefficient pumping ability. The kidneys respond to the change by making the body retain fluids and salts. This abnormal retention leads to congestion in the body, and the condition is termed as congestive heart failure.

There are many heart diseases affecting a large portion of the population, and there are many reasons behind congestive heart failure. Coronary Artery Disease is one of them.

What is a Coronary Artery Disease?

Coronary arteries are blood vessels that supply heart muscles. A blockage may arise there if plaque builds up in the vessels. Plaque is a substance which is made up of bad cholesterol, calcium, fats, and blood cells. It narrows down the vessel. It may eventually block the blood vessel. This will lead to chest pain. In severe cases, it can lead to heart attack, heart failure, and also sudden death! Heart attack is a process wherein the blood flow to muscles of the heart is stopped; it results in death of the muscles.

What is a Coronary Artery Bypass Surgery?

In the above cases, a surgery is performed to correct the defect. Through this surgery, blood flow is restored back to normal by removing the waxy substance called plaque from the arteries. CABG is the surgical intervention on the heart which is performed to improve the blood flow and pumping action of the heart. It is indicated for patients who present with severe coronary heart diseases.

Is it right for you?

It is decided based on several factors, such as your symptoms, your health, and other diseases that you are suffering from. CABG is highly recommended for you if you have tried many other treatments which have failed to get rid of the plaque and the complaints that have followed. In many cases, stents fail to open the blockages or a regime involving exercise, medicines, and diet changes doesn’t help. Sometimes, the individuals also end up developing new blockages. Under such circumstances, it is best for you to consider visiting a best cardiac surgeon near you and follow his advice.

CABG is performed if you have:

1. A stable angina: Chest pain that is certain in terms of occurrence, frequency, duration, severity, and triggering factors is called as a stable angina.

2. Heart attack

3. Extensive blockage: Extensive blockage is when several coronary blood vessels are narrowed, including the main vessels, accompanied by poor pumping function.

4. If your doctor suspects that you are at risk: Based on your limitations while exercising, your doctor will decide if you are at a risk. Also, if your blood pressure is not rising to the required limit while exercising, your doctor may want to perform CABG.

How is it done?

• A blood vessel from your chest or from your legs is taken.
• The point where the blockage has happened is located.
• Below that point, the blood vessel is attached. Another end of that blood vessel is attached to the aorta, a big blood vessel that originates from your heart and supplies oxygen-rich blood to various parts of your body.
• Thus the blood flow is restored back to normal. More than one blockage may be corrected at a time.

Here’s the process to help you be prepared:

• You will be given general anesthesia.
• The surgery may take 3 to 6 hours.
• After the surgery, you will be shifted to an intensive care unit (ICU) for one to two days. Your family will be allowed to visit you briefly.
• When you wake up after the surgery, you may feel totally disoriented. You may lose track of time as the lights are always on in the ICU.
• A tube will be in your mouth, passing through your throat to help you breath. It will be removed immediately after you are able to breathe on your own. It’s likely that you will be uncomfortable and will not be able to talk. However, your nurse will help you communicate.
• A catheter/pipe is entered into your urinary bladder to collect your urine. It will be removed immediately after you are able to move and are able go to the washroom.
• You are connected to machines that monitor your blood pressure and heart rate for 12 to 24 hours.
• You will have an intravenous (IV) inlet in your arms. This will help inject medicines, which keep up your blood circulation and maintain your blood pressure. Once you are able to have food, this will be removed.
• You will be shifted to a ward in a day or two.
• The incision that is made in your chest during surgery will be sore for 48 to 72 hours. You will be given painkillers and other medications.
• You might be coughing harder to get rid of excess fluid that has entered your lungs.
• You can walk and move right away.
• You can have a normal diet.

The prognosis after the CABG surgery is usually excellent. According to reports, most of the patients live symptom-free for many years. In extreme cases, surgery is performed again if new blockages have developed in arteries or veins which weren't blocked earlier. The affected and operated individuals should consider lifestyle changes to prevent the blockages from reappearing.