Coronary Artery Bypass in India

Coronary Artery Bypass

CABG involves taking a blood vessel from another part of the body, usually the chest or leg, and attaching it to the coronary artery above and below the narrowed area or blockage. This new blood vessel is known as a graft.

The graft diverts the flow of blood around the part of the coronary artery that is narrowed or blocked. Usually, the surgeon will carry out several grafts to make sure the procedure does not have to be repeated in the future.

About the Procedure

CABG surgery usually lasts three to six hours. However, it may take longer depending on how many blood vessels are being grafted.

Blood vessels can be taken from:

your leg: this vessel is known as the saphenous vein
inside your chest: this vessel is known as the internal mammary artery
your arm: this vessel is known as the radial artery

The number of vessels needed will depend on how severe your coronary heart disease is and how many of the coronary blood vessels have become narrowed. Most people will need three to four vessels grafted. One of the graft vessels is usually your internal mammary artery. Surgeons prefer to use this vessel because it does not narrow over time, unlike the blood vessels taken from your leg or arm.

Once all the graft vessels have been taken, your surgeon will make a cut (incision) down the middle of your breastbone (sternum) to access your heart through your ribcage. During the procedure, your blood will be re-routed to a heart-lung bypass machine. This takes over from your heart and lungs, pumping blood and oxygen through your body.

Your heart will be temporarily stopped using medication, while your surgeon attaches the new grafts to divert the blood supply around the blocked artery. After the grafts have been attached, your heart will be started again using controlled electrical shocks. Your sternum will then be stitched up using wires and the skin on your chest sewn up using dissolvable stitches.

Why is it performed?

A coronary artery bypass graft (CABG) may be necessary:

if there is severe hardening and narrowing of the coronary arteries
if many coronary blood vessels are blocked
if you are at risk of having a life-threatening heart attack
to restore blood supply after a heart attack
as emergency treatment for ventricular arrhythmia

Before the procedure

Your doctor will give you specific instructions about how to prepare for surgery. He or she will advise you about what to eat or drink, what medicines to take, and what activities to stop (such as smoking). You’ll likely be admitted to the hospital on the same day as the surgery.

If tests for coronary heart disease show that you have severe blockages in your coronary (heart) arteries, your doctor may admit you to the hospital right away. You may have CABG that day or the day after.

After the procedure

Recovery in the hospital:

Tests may be done to prepare you for coronary artery bypass grafting (CABG). For example, you may have blood tests, an EKG (electrocardiogram), echocardiography, a chest x ray, cardiac catheterization, and coronary angiography. Your doctor will give you specific instructions about how to prepare for surgery. He or she will advise you about what to eat or drink, what medicines to take, and what activities to stop (such as smoking). You’ll likely be admitted to the hospital on the same day as the surgery. If tests for coronary heart disease show that you have severe blockages in your coronary (heart) arteries, your doctor may admit you to the hospital right away. You may have CABG that day or the day after.

Recovery at Home:

Your doctor will give you specific instructions for recovering at home, especially concerning:

How to care for your healing incisions
How to recognize signs of infection or other complications
When to call the doctor right away
When to make followup appointments

You also may get instructions on how to deal with common side effects from surgery. Side effects often go away within 4 to 6 weeks after surgery, but may include:

Discomfort or itching from healing incisions
Swelling of the area where an artery or vein was removed for grafting
Muscle pain or tightness in the shoulders and upper back
Fatigue (tiredness), mood swings, or depression
Problems sleeping or loss of appetite
Constipation
Chest pain around the site of the chest bone incision (more frequent with traditional CABG)

Full recovery from traditional CABG may take 6 to 12 weeks or more. Less recovery time is needed for nontraditional CABG. Your doctor will tell you when you can start physical activity again. It varies from person to person, but there are some typical timeframes. Most people can resume sexual activity within about 4 weeks and driving after 3 to 8 weeks. Returning to work after 6 weeks is common unless your job involves specific and demanding physical activity. Some people may need to find less physically demanding types of work or work a reduced schedule at first.

Risks

Although complications from coronary artery bypass grafting (CABG) are uncommon, the risks include:

Wound infection and bleeding
Reactions to anesthesia
Fever
Pain
Stroke, heart attack, or even death
Chest pain, irritability, and decreased appetite
Memory loss and other changes, such as problems concentrating or thinking clearly

Outlook (Prognosis)

CABG is not a cure for coronary heart disease (CHD). You and your doctor may develop a treatment plan that includes lifestyle changes to help you stay healthy and reduce the chance of CHD getting worse.
Lifestyle changes may include making changes to your diet, quitting smoking, doing physical activity regularly, and lowering and managing stress. Your doctor also may refer you to cardiac rehabilitation (rehab). Cardiac rehab is a medically supervised program that helps improve the health and well-being of people who have heart problems.

Rehab programs include exercise training, education on heart healthy living, and counseling to reduce stress and help you return to an active life. Doctors supervise these programs, which may be offered in hospitals and other community facilities. Talk to your doctor about whether cardiac rehab might benefit you. Taking medicines as prescribed also is an important part of care after surgery. Your doctor may prescribe medicines to manage pain during recovery; lower cholesterol and blood pressure; reduce the risk of blood clots forming; manage diabetes; or treat depression.

FAQ’s

What is the duration of stay for Coronary Artery Bypass Surgery?
The total duration of stay for Coronary Artery Bypass Surgery is 15 days. The patient needs to spend 7 days at the hospital to undergo the surgical procedure and spend the remaining 8 days outside the hospital for post procedure recuperation.

What is the cost of the procedure & the expected cost savings for a medical tourist?
Coronary Artery Bypass Surgery costs approximately USD 9300 in India. For a medical tourist, this translates to savings of around 80% to 90% depending on the country of origin.
Note:
1) The price quoted above is a very close estimate of the actual cost. The actual cost will vary based on the hospital, the condition of the patient and the time of admission.
2) The procedure cost does not include the price of airfare and hotel booking. We can help you get the best deals for airline and hotel bookings at no extra costs through our travel partners.

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