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Site FeedbackCardiac Surgery (CABG, "Cabbage")
Description | Treatment Options | John Muir Health Capabilities
Definition
Cardiac Surgery, sometimes called "Open heart surgery," is indicated as a treatment for blocked or narrowed heart arteries. The purpose is to increase the circulation and oxygen delivery to the heart muscle. The medical term used is Coronary Artery Bypass Graft (CABG).
Description
Coronary artery bypass surgery began in the late 1960s as one method used for treating coronary artery disease (CAD). CAD causes narrowing or compete blockage in one or more of the coronary arteries. The result is restricted flow to the heart muscle. Decreased flow can lead to angina (chest pain), heart attack, heart failure or death.
During surgery, a piece of a long vein in your leg may be taken. One end is sewn onto the large artery leaving your heart -- the aorta. The other end of the vein is attached or "grafted" to the coronary artery below the blocked area. Another method uses an artery from the chest wall. One end is attached to the diseased coronary artery below the blocked area thereby delivering oxygen rich blood. The heart surgeon detaches an artery from inside the chest wall and re-attaches it to the clogged coronary artery below the blockage. Either way, blood can use a new path to flow freely to the heart muscle. More than one "detour" may be necessary. One may need one, two, three or more bypasses, depending on how many coronary arteries are blocked. The technique used for cardiac surgery has changed over the years. Improved surgical technique, advance technology, and expert clinical care has shortened the hospital stay from weeks to days. Many individuals will go home 5-6 days after surgery, some less.
The heart cath is used as both an evaluation procedure and a treatment procedure. A heart cath is often performed as an emergency treatment for a heart attack or as a planned procedure to evaluate a heart-related complaint. As the evaluation or diagnostic examination proceeds, problem areas may be seen. The doctor may choose to repair, or treat, the artery narrowing at that time. The doctor may use a special balloon to open the blocked artery (angioplasty) and/or a metal spring-like device (stent) to support the artery wall.
Treatment Options
Current techniques for cardiac surgery include the standard use of cardiopulmonary bypass pump and what is called minimally invasive cardiac surgery. Traditional cardiac surgery uses a pump oxygenator, sometimes called a heart-lung machine during surgery. During surgery, blood is circulated through the heart-lung machine. This allows the surgeon to temporarily stop the beating heart. When the grafts are completed, the heart is restarted and resumes pumping blood through the body.
Recent technology allows the surgeon to operate on a beating heart thus eliminating the need for the heart-lung machine. This method is call "off pump" bypass surgery and is used in selective cases. It's done while the heart is still beating. The surgeon views and performs the attachment directly, so the artery to be bypassed must be right under the incision.
After cardiac surgery, the patient is moved to a hospital bed in the cardiac surgical intensive care unit. Expert nurses will continue to monitor heart rate and blood pressure using very special equipment. The hospital stay is at least three to five days. After release from the hospital, individuals may experience side effects such as:
- Loss of appetite, constipation
- Swelling in the area from which the segment of blood vessel was removed
- Fatigue, mood swings, feelings of depression, difficulty sleeping
- Muscle pain or tightness in the shoulders and upper back
Many of these side effects usually disappear in four to six weeks, but a full recovery may take a few months or more. When the patient is ready, he or she may be enrolled in a physician-supervised program of cardiac rehabilitation.
John Muir Health Capabilities
John Muir Health has offered cardiac surgery since 1972. Both medical centers have several full service cardiac surgery suites and expert surgical staff available 24 hours a day, 7 days a week. Five cardio-thoracic surgeons are on staff at John Muir Health. Expert cardiac anesthesiologists are available at each medical center. The surgical support staff and the clinical staff are highly trained in all aspects of cardiac care.
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