Coronary Bypass Graft
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1- Introduction
2- Anatomical Overview
3- Clinical Significance
Introduction
coronary artery bypass graft (CABG) surgery, is a surgical procedure used to treat coronary artery disease (CAD). CAD occurs when the blood vessels that supply blood to the heart become narrowed or blocked by a buildup of plaque, reducing blood flow to the heart muscle.During CABG surgery, a surgeon takes a healthy blood vessel from another part of the body, such as the chest, leg, or arm, and grafts it onto the coronary artery beyond the blockage. This creates a new route for blood to flow to the heart, bypassing the blocked or narrowed section of the artery.
Anatomical Overview
During coronary artery bypass graft (CABG) surgery, the surgeon first harvests a healthy blood vessel, called a graft, from another part of the body. Common graft sources include the internal mammary artery (from the chest) and the saphenous vein (from the leg). Occasionally, other arteries or veins may be used as grafts.
Once the graft is harvested, the surgeon makes an incision in the chest to access the heart. The patient is typically connected to a heart-lung bypass machine, which takes over the function of the heart and lungs during the procedure. However, in some cases, off-pump or “beating heart” surgery may be performed, where the heart continues to beat during the procedure and the bypass machine is not used.
The surgeon then attaches one end of the graft to the aorta (the main artery that carries oxygenated blood from the heart to the body) and the other end to the coronary artery beyond the blockage. This creates a new pathway for blood to flow to the heart muscle, bypassing the blocked or narrowed section of the coronary artery.
The number of grafts needed depends on the number and location of blockages in the coronary arteries. Some patients may only need one graft, while others may need multiple grafts to restore adequate blood flow to the heart.
Clinical Significance
Relieve angina: Angina is chest pain or discomfort that occurs when the heart muscle doesn’t get enough oxygen-rich blood. By bypassing blocked or narrowed arteries, CABG surgery can improve blood flow to the heart, reducing or eliminating angina symptoms.
Reduce the risk of heart attack: By restoring blood flow to the heart muscle, CABG surgery can reduce the risk of heart attack, which occurs when blood flow to a part of the heart is blocked completely, leading to damage to the heart muscle.
Improve heart function: In some cases, CABG surgery can improve the overall function of the heart, particularly in patients with severe CAD and heart failure.
Prolong life: CABG surgery has been shown to prolong life in patients with severe CAD, particularly those at high risk for heart attack or other complications.
Improve quality of life: By relieving symptoms and improving heart function, CABG surgery can improve the quality of life for patients with severe CAD.