Coronary Artery Bypass Grafting (CABG) or commonly known as heart bypass surgery is a surgical procedure intended for people with coronary heart disease. The purpose of carrying out this procedure is to create a new channel through blood vessels that are blocked due to narrowed arteries that are blocked due to a buildup of plaque or fat in the arteries. The buildup of plaque or fat itself can cause a rupture of the arteries and form blood clots which can lead to a lack of oxygen in the heart and cause the heart to stop functioning, triggering a heart attack.
In general, heart bypass surgery is not the first choice in dealing with coronary heart disease because even though it can reduce the risk of heart attack, relieve chest pain symptoms, and increase life expectancy by up to 10 years, this operation has quite high risks.
When Should Heart Bypass Surgery Be Considered?
Heart bypass surgery should be considered if:
- The patient's heart disease cannot be treated with angioplasty and/or heart ring insertion (a minimally invasive procedure to widen narrowed arteries by inflating a balloon that is inserted through a catheter).
- If more than one coronary artery is blocked.
- The heart is weakened due to some blockages.
- Left coronary artery occluded.
Until now, there are as many as 10% of coronary heart disease patients are treated with heart bypass surgery.
What is the Procedure for Heart Bypass Surgery?
In general, heart bypass surgery takes 3-6 hours depending on how many blood vessels are grafted to replace the function of the narrowed blood vessels. Making this alternative route can be operated using a cardiopulmonary bypass machine, there are also techniques without using a cardiopulmonary bypass machine, the heart is operated on in a throbbing state. This technique there are several advantages compared to techniques using a heart-lung bypass machine, then the blood vessels from the legs (saphenous vein), chest (internal mammary artery), or arm (radial artery).
The blood vessel will then be removed and the doctor will make an incision in the sternum so it can reach the heart. Then, the heart will be stopped from pumping for a while so the doctor can attach the grafted blood vessel.
During the procedure, the function of flowing blood throughout the body performed by the heart is replaced by a heart-lung bypass machine so that other organs continue to receive oxygen as long as blood flow to the heart is improved.
Once blood flow to the heart has been repaired and the graft is made, the patient's heart is given controlled force electric shocks to get it pumping again. Finally, the incised sternum is put back together with wire and the skin is sutured with thread.
What Are the Side Effects or Risks of Heart Bypass Surgery?
One of the worst side effects or risks of bypass surgery is death and this occurs in 3% of the total number of patients. Death can occur either during the operation after the operation is finished, or sometime after the operation (due to a heart attack).
Along with current technological advances and surgical capabilities, the postoperative heart surgery success rate has greatly improved compared to the past decade. However, there can still be some postoperative complications, so it's best to discuss it with your heart surgeon.
The article was written by dr. Marolop Pardede, Sp.BTKV(K), MH (Specialist in Thoracic, Cardiac, and Vascular Surgery at EMC Cikarang & Pekayon Hospital).