Melissa Perry

Coronary Artery Bypass Grafting

Coronary Artery Bypass Grafting (CABG) is a heart surgery that helps improve
the flow of blood to the heart. CABG is one of the treatments used for people with
severe coronary heart disease. Coronary eart !isease occurs when the coronary
arteries" which supply o#ygen$rich blood to the heart" are filled with pla%ue. &hen the
pla%ue hardens" it reduces the blood flow and narrows these arteries. 'f the pla%ue
ruptures" a blood clot can form and this may bloc( the blood flow through a coronary
artery causing a heart attac(. ())
&ith the CABG procedure" a healthy vein or artery from the body is grafted to the
coronary artery that is bloc(ed. *he vein typically comes from the leg" which allows the
blood to flow directly into the heart muscle. (+) *he grafted vein or artery that was used
goes around the bloc(ed portion and creates a new path. *his allows o#ygen$rich blood to
flow smoothly through the coronary artery to the heart. *here are several types of CABG"
including *raditional CABG" ,ff$Pump CABG" and Minimally 'nvasive !irect CABG.
*raditional Coronary Artery Bypass Grafting is used when one of the ma-or arteries
needs to be bypassed. *his involves the chest bone being opened in order to access the
heart. Medicines are given to stop the heart and a heart$lung bypass machine is used to
(eep the blood and o#ygen flowing throughout the body. *he ,ff$Pump CABG
procedure also involves opening the chest bone to access the heart" but a heart$lung
bypass machine is not used and the heart isn.t stopped. *he third procedure" the
Minimally 'nvasive !irect CABG" is a type of surgery where several small cuts are made
between the ribs on the left side of the chest. *his procedure is used to bypass blood
vessels near the front of the heart. ())
Melissa Perry
*here are two general indications that %ualify people to be candidates of
revasculari/ation surgery. *he first sign is the presence of intolerable symptoms. *his can
be due to either the restriction of physical activity and lifestyle or because of the side
effects from their medications. *he second sign might be the presence of coronary
arteriographic findings that indicate the patient would have a better prognosis with
revasculari/ation than with another form of medical therapy. Additional considerations
for CABG candidates include age" family history of C! and other diseases" the e#tent
and severity of Myocardial 'nfarction on noninvasive testing" the presence of other
conditions" degree of left ventricular (01) dysfunction" and the severity of coronary
artery disease. (2)
*horough preoperative evaluations are e#tremely necessary in order to reduce the
volume of high ris( patients. 3our doctor will first perform a physical e#am" an
4lectrocardiogram test" an 4chocardiography test" a stress test" and a Coronary
Angiography and Cardiac Catheteri/ation procedure to decide on whether or not you are
a candidate for CABG. ()) ,nce patients are approved and have decided to undergo the
CABG surgery" they need to be medically stabili/ed. Any patient who undergoes surgery
needs to be on Beta$bloc(ers. 'f the patient has 01 dysfunction" then angiotensin
converting en/yme inhibitors (AC4') need to be given. Patients should also be on
antiplatelet therapy and at a functional and stable level prior to CABG. (5)
Coronary Artery Bypass Grafting can improve the patients. %uality of life and
reduce the symptoms associated with C!. 6ot only does CABG allow you to have an
active lifestyle again" but it also improves the pumping of the heart" lowers your chance
of a heart attac(" and greatly improves your chance of survival. *he results of CABG are
Melissa Perry
e#traordinary and the surgery improves or completely relieves angina symptoms in the
ma-ority of patients. ())
!irect coronary artery revasculari/ation is the primary surgical treatment for
people with ischemic heart disease. !uring the past three decades" surgical advancements
have improved event$free survival" smoothed the progress of postoperative care" and have
decreased the mortality and morbidity of coronary artery bypass surgery. (7) Although it
is possible that symptoms can recur" the ma-ority of people remain symptom$free for up
to )7 years ()).
Melissa Perry
REFERENCES
1. 8.9. !epartment of ealth and uman 9ervices. Coronary Artery Bypass Grafting.
Available at http:;;www.nhlbi.nih.gov;health;health$topics;topics;cabg;. Accessed
!ecember )+" +<)2.
2. Mahan 0=" 4scott$9tump 9. Krauses Food and Nutrition Therapy. )+
th
4d. 9t. 0ouis:
9aunders 4lsevier> +<<?.
3. ,.@our(e @" &alsh @" Auster 1. Hursts: The Heart-Manual of Cardiology. )+
th
4d.
Chicago: McGraw ill Companies> +<<B.
4. 6guyen *6" u !" =im M" Grines C0. Management of Complex Cardiovasular
!ro"lems. 2
rd
4d. Malden: Blac(well Publishing> +<<C.
5. Crawford 0" !iMarco M" Paulus C*. Cardiology. 2
rd
4d. Philadelphia: 4lsevier> +<)<.