Coronary Artery Bypass Grafting (CABG), commonly known as bypass surgery or heart bypass surgery, is a surgical procedure used to treat coronary artery disease (CAD), a condition in which the blood vessels that supply oxygen-rich blood to the heart muscle become narrowed or blocked due to the buildup of fatty deposits called plaques. These blockages can restrict blood flow, leading to chest pain (angina), heart attack, or even heart failure.
During CABG, a skilled cardiac surgeon creates new pathways for blood to flow around the blocked or narrowed coronary arteries. This is achieved by using healthy blood vessels harvested from other parts of the body, usually the chest wall, leg, or arm, to create bypasses. These grafts are carefully connected to the heart’s arteries, rerouting blood flow and bypassing the obstructed areas.
Anesthesia: The patient is given general anesthesia, rendering them unconscious and pain-free throughout the surgery.
Harvesting of Blood Vessels: The surgeon selects appropriate blood vessels (usually the internal mammary artery, radial artery, or saphenous vein) and prepares them for use as bypass grafts.
Opening the Chest: A vertical incision is made in the middle of the chest to expose the heart.
Connecting the Bypass Grafts: The surgeon then attaches one end of the harvested blood vessel to the aorta (the main artery that carries oxygenated blood from the heart), and the other end is attached to the coronary artery downstream from the blockage.
Completing the Bypass: The blood now flows through the newly created bypass, effectively restoring blood supply to the heart muscle beyond the blockage.
Causes: The most common cause of PVD is atherosclerosis, a condition in which fatty deposits (plaque) build up on the walls of arteries, leading to narrowing and reduced blood flow. Other possible causes include inflammation of blood vessels, blood clots, injury to blood vessels, and vasculitis (an autoimmune condition causing blood vessel inflammation).
Symptoms: In the early stages, PVD may not cause noticeable symptoms, or the symptoms may be subtle. As the disease progresses, the following symptoms may occur:
Pain or cramping in the legs (claudication) during physical activity, which improves with rest. Numbness or weakness in the legs. Coldness in the lower extremities Changes in skin color or shiny skin on the legs. Slow-healing sores or ulcers on the feet or legs. Weak pulse or no pulse in the affected limb. Erectile dysfunction (in men) – due to impaired blood flow to the genital area.
Treatment: The management of PVD involves lifestyle changes, medications, and, in some cases, surgical interventions. The goal is to improve blood flow, alleviate symptoms, and prevent further complications. Treatment options may include:
Lifestyle changes: Quitting smoking, regular exercise, and adopting a heart-healthy diet.
Medications: Blood-thinning medications, cholesterol-lowering drugs, and medications to control blood pressure and blood sugar levels.
Angioplasty and stenting: A procedure to open narrowed arteries and place a stent to keep them open.
Bypass surgery: Surgical rerouting of blood flow around blocked arteries.
Thrombolytic therapy: Medications to dissolve blood clots.
Prevention: Preventing PVD involves maintaining a healthy lifestyle, managing risk factors, and getting regular check-ups. This includes avoiding smoking, staying physically active, eating a balanced diet, controlling blood pressure and cholesterol levels, and managing diabetes if present.