Which Graft to Use for Coronary Artery Bypass Graft Surgery?

Overview

Coronary artery disease (CAD) has become one of the most common causes of heart disease worldwide. In the US, it has become a prominent cause of death over the last few decades. However, there’s a lot more you can do to prevent such heart issues. Due to recent advancements in the medical field, CABG (coronary artery bypass graft) has become an effective treatment option that can reduce mortality and improve the overall quality of life. Here’s everything you need to know about the graft or vein i.e used for coronary bypass surgery.

Which graft to choose for heart bypass surgery?

As suggested by cardiologists, the choice of the bypass graft can be made based on the following factors:

• The overall health of the patient
• The size of the coronary artery
• The location and extent of the blockage
• Availability of veins and arteries

Internal thoracic artery- internal thoracic (mammary) artery (ITA) grafts are the most widely used bypass grafts and have the best long-term results. The artery is usually left intact at its origin, with the other end stitched to the coronary artery below the obstruction.

In addition to the left ITA, the right ITA is frequently used in patients aged 65 and younger, — as well as in older but otherwise relatively healthy patients when more than one graft is required.

Radial artery: In addition to the left ITA, the right ITA is frequently used in patients aged 65 and younger, as well as in older but otherwise relatively healthy patients when more than one graft is required. RA grafts operate best when placed on an artery with a blockage of at least 70%, ideally more.

When a third arterial graft is required or when a patient requires two arterial grafts but the appropriate ITA is unavailable, RA grafts are indicated for young patients.

Saphenous vein: The saphenous vein (SPV) is a regularly used bypass conduit due to the ease of harvest, which can often be done with minimally invasive operations, resulting in less scarring and faster recovery. However, long-term vein graft failure remains a significant issue. Variable quality and size of the veins, the existence of valves within the veins, and the potential for areas of dilatation (varicosities) inside the veins are all reasons for increased failure rates.

Also, Read - Coronary Artery Bypass Grafting - CABG Symptoms, Risks, Treatment

Traditional coronary artery bypass graft:

• This sort of operation typically takes three to five hours to complete, depending on the number of arteries bypassed. Several steps are taken during standard CABG.

• Anesthesia is administered to put you to sleep. The anesthesiologist checks your heart rate, blood pressure, oxygen levels, and breathing during the operation. A breathing tube is inserted through your throat into your lungs and attached to a ventilator (breathing machine).
• An incision is created across the middle of your chest. The surgeon will then cut your chest bone and open your ribcage to access your heart.
• Medicines are used to temporarily stop your heart, allowing the surgeon to operate on it while it is not beating. A heart-lung machine circulates oxygen-rich blood throughout your body.
• An artery or vein is removed from another region of your body, such as your chest or leg, and prepared to be utilized as a graft for bypass surgery. A combination of artery and vein grafts is routinely used in surgery with multiple bypasses.

Also, Read - Understanding The CABG Surgery Complications

Recently used Off-pump CABG surgery:

This procedure can be used to circumvent any of the coronary arteries. Because the heart is not halted and no heart-lung machine is used, off-pump CABG is also known as beating heart bypass grafting. Instead, a mechanical device is used to stabilize the area of the heart where the grafting is taking place.

Off-pump CABG may reduce complications associated with the use of a heart-lung machine, particularly in people who have had a stroke or "mini-strokes" in the past, are over 70, and have diabetes, lung illness, or renal disease.

Also, Read - Heart Bypass Surgery Age Limit

How can we help with the treatment?

If you are in search of CABG treatment in India, we will serve as your guide throughout your treatment and will be physically present with you even before your treatment begins. The following will be provided to you:

• Opinions of expert physicians and surgeon
• Transparent communication
• Coordinated care
• Prior appointment with specialists
• Assistance with hospital formalities
• 24*7 availability
• Arrangements for travel
• Assistance for accommodation and healthy recovery
• Assistance in emergencies

We are dedicated to offering the highest quality health trip and care to our patients. We have a team of highly qualified and devoted health professionals that will be by your side from the beginning of your journey.