CABG

Question 1

What is a CABG?

Answer 1

Coronary artery bypass surgery: Is a surgical procedure that involves bypassing the blocked portion of a coronary artery with another piece of blood vessel usually the saphenous artery. Performed to relieve angina and reduce risk of death from coronary artery disease.

Surgeon makes a sternotomy to open the chest

Question 2

What are the indications for CABG?

Answer 2

CHD or CAD: where there is a build of of plaque or atheroma in the arteries. These harden over time and leading narrowing of blood vessels, reducing blood flow to the heart. This can cause angina. If a plaque ruptures a blood clot can form on the surface and if big enough can block blood flow causing a myocardial infarction.

Question 3

Complications of CABG and surgery?

Answer 3

Non union of sternum
MI due embolism or graft failure
Grafts only last 10-15 years
Pneumothorax : air in pleural space secondary to a rupture in either pleural layer
Pleural effusion : excess fluid in pleural cavity

General risks of surgery
Pain
Infection
Death
Affects of general anaesthesia - detrimental affect on respiratory function. Impairs CNS regulation of breathing leading to hyperventilation and supine position can = atelectasis and sputum retention

Question 4

Post op treatment?

Answer 4

Building up exercise tolerance

12 week program of exercise gradually increasing about 2 weeks after surgery.

Question 5

Prognosis

Answer 5

Very good outlook
Reduces risk of MI
Surgery relieves symptoms of angina in most people
May require surgery again in 10-15 years if blockages form in the grafted vessels