An Overview of Coronary Heart Bypass Surgery

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An Overview of Coronary Heart Bypass Surgery
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History

• In the late 1930s, Dr. John Gibbon performed a
  cardiopulmonary bypass (CPB) with the help of the
  heart-lung machine.
• In 1953, D. W. Gordon Murray reported placement
  of arterial grafts in the coronary circulation
• In 1955, Sidney Smith was the first to produce
  saphenous vein and employ it as a graft from
  aorta to into the myocardium.
• In 1958, Longmire performed the first open
  coronary artery endarterectomy without CPB at
  University of California at Los Angeles (UCLA).

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Continued

• In 1961, Dr. Robert Goetz executed the first
  human coronary artery bypass operation
  successfully.
• In 1962, Proud fit by visualizing the coronary
  arteries conducted the first practical cardiac
  angiography successfully.
• In 1964, Kolovos performed the first internal
  mammary artery-coronary artery anastomosis.
• In the 1970s, continued development of technique
  and conduits took place.

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Definition
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• Coronary artery bypass grafting (CABG) refers to
  a procedure, wherein, the blocked coronary
  arteries are bypassed with the help of a blood
  vessel graft in order to restore normal flood
  flow to the heart.
• It alleviates angina, pain and diminishes the
  associated heart attack risks leading deaths.

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Procedure Involved
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• The procedure of CABG can be divided into two
  main stages, that includes
• Stage 1 the healthy blood vessel (the graft) is
  removed from body parts like chest wall or leg.
• Stage 2 The graft is connected to the coronary
  artery by bypassing the diseased segment- it
  improves the blood flow to the heart

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Latest Developments

• A surgical robot is used to perform CABG in a
  minimally-invasive way- it does not require an
  incision, decreasing the patients recovery
  period to a few weeks
• Keyhole surgery Much different to the
  traditional surgical methods, it requires an
  incision that varies from 2 to 3 inch.
• Minimally-invasive surgery and stented
  angiosplasty in one-Hybrid procedures.
• Beating heart bypass or off-pump.

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Off Pump CABG
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• This CABG is performed without the use of a
  heart-lung machine (cardiopulmonary bypass)
• In this procedure, the bypass is sewed onto the
  heart, while the heart keeps on beating.
• For the surgeon to commence the operation, a wide
  range of heart stabilizers are used to restrain
  the heart one section at a time

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Advantages of Off-Pump Over on Pump CABG

• Lesser need of blood transfusions
• Diminished risk of bleeding, stroke and kidney
  failure.
• Patients who are at a risk of health ailments
  such as lung disease, kidney failure, peripheral
  vascular disease can greatly benefit from this
  operation.

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Possible risks

• Blood clots that may elevate the risks of a
  stroke, heart attack, or lung problems
• Bleeding, infection and difficulty in breathing
• Abnormal heart rhythms (arrhythmias)
• Pneumonia, Fever and pain

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