Coronary Artery Bypass Graft

(CABG)

<Surgery>

<Index>

 

 

 

Rationale

-  Improve perfusion to myocardium by grafting vessels onto coronary arteries

-  Indicated for coronary artery disease, IHD

-  Preferred treatment for

-  Disease of Left Main Coronary Artery (LMCA)

-  Triple vessel disease (Left Anterior Descending (LAD), Left Circumflex (LCX), Right Coronary Artery (RCA))

 

Features

-  Termed single, double, triple .. bypass based on number of coronary arteries bypassed

-  Performed on pump with cardiopulmonary bypass OR off pump wo

-  Grafts last an avg 10-15 yrs

 

Procedure

-  GA

-  Median sternotomy

-  Grafts harvested from internal thoracic artery (on pedicle), radial artery or saphenous vein

-  Heparin

-  +/- cardiopulmonary bypass

-  Grafts inserted to bypass diseased coronary arteries

-  Heart restarted

-  Protamine (to reverse Heparin)

-  Sternum wired together, incisions sutured

-  1-2 days ICU, 4-5 days CCU

 

   

Complications

-  Care to avoid placing strain on sternotomy wound

-  Postreperfusion syndrome: transient neurocognitive impairment ass w cardiopulmonary bypass

-  AMI: graft failure, hypoperfusion, embolism

-  Stroke: hypoperfusion

-  ARF: hypoperfusion

-  Graft stenosis