Wockhardt Hospital- Speciality Information Series on CABG Surgery

Speciality Information Series by

Wockhardt Hospitals

Coronary Artery Bypass Graft

Surgery (CABG)

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super specialty healthcare networks in India.• Pan India presence with 8 multi-specialty

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• NUSI Wockhardt Hospital, Goa• Wockhardt Heart Hospital, Nagpur• Wockhardt Super Speciality Hospital, Nagpur• Wockhardt Hospitals, Nashik• N M Virani Wockhardt Hospital, Rajkot• Adventist Wockhardt Heart Hospital, Surat• Wockhardt Hospitals, Bhavnagar• Sterling Wockhardt Hospital, Vashi• Wockhardt Hospitals, South Mumbai

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Surgery

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Heart Care @ Wockhardt• Leaders in Heart Care in India since

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• Interventional Cardiac Procedures• Cardiothoracic and Vascular Surgery procedures• Pediatric Cardiology and Cardiac Surgery

• Our Differentiators:• World-class Care• State of art technology• Best in class medical expertise

• Our achievements include• World’s first conscious off pump Coronary

Artery Bypass surgery.

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Coronary Artery Bypass Graft Surgery (CABG)

• What is CABG Surgery?– Plaque formations in heart due to ageing or

cholesterol and mineral deposits may cause blood clots in arteries or restricted blood flow to the heart.

– CABG surgery is an open-heart operation in which arteries or veins are taken from another part of the body to channel needed blood flow to the coronary arteries.

– During surgery, these arteries or veins are connected directly to the coronary arteries on the surface of the heart beyond the blockages. This way, blood can flow through them to bypass the narrowed or closed points.

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Conscious off-pumpcoronary artery bypass surgery• What is conscious off-pump coronary

artery bypass surgery (awake bypass surgery)?– Conscious off-pump coronary artery bypass

surgery is a break through step in “Fast-track care “of bypass surgery patients.

– Awake bypass surgery is the latest advance in beating heart surgery which is performed with epidural anesthesia, eliminating the need and risks of general anesthesia.

– The patient undergoes painless bypass surgery while actually awake and can converse with the operating surgeon and his team.




Awake bypass surgery procedure

• How is awake bypass surgery performed?– Awake bypass surgery uses a precision

based technique, which involves injection of micro doses of local anesthesia that anesthetizes only the chest region while the rest of the system is fully awake.

– When the anesthetic medicine is steadily delivered to the epidural space of the spine, the patient feels no pain in the chest area.

– Minimal medication is given to reduce anxiety and the patient remains awake during the entire surgery.




What are the patient benefits with Awake bypass surgery?

• Awake bypass surgery offers many benefits for the patient. They are:– No general anesthesia– Can be performed for high-risk group of

patients who were earlier termed in-operable because of risk of general anesthesia

– Avoidance of cardiac depression due to general anesthesia and premedication drugs.

– No post-operative ventilator support required which reduces post-operative intensive care to less than 24 hours

– Overall hospitalization can be reduced by 3 days.




What is the pre-surgery hospital procedure?

• Preparing for your surgery• Typically a patient is admitted to the

hospital with enough time before the operation date to allow diagnostic tests to be done.

• These routinely include blood and urine tests, chest x–rays, electrocardiograms (ECGs) and so on.

• Cardiac catheterization with coronary angiograms is done during the pre-operative hospital stay.




Blood used during surgery• There is an option of Pre-

donation for blood transfusion during surgery

• If you are found to be fit, one or two bottles of your own blood may be drawn before surgery which will be used for blood transfusion, during or after surgery.

• It is the safest blood transfusion, and eliminates or reduces the need for donor blood transfusion.

• This may be done before or after your admission, on the decision of your cardiovascular surgeon.




Before the Operation– Most of your body hair will be shaved off,

especially from your chest and legs.– You will be asked to shower to remove

bacteria from the skin to reduce the chance of infection.

– Personal items such as glasses, contact lenses, dentures, detachable bridge work, watches and jewellery will have to be removed for safe keeping.

– Medications that will make you relaxed and drowsy will be given about an hour before the operation.

– Attendants will wheel you to the operating room on a rolling bed.

– In the operating room, an anesthetic that brings sleep and freedom from pain during the operation will be given.




After the operation• Patient is taken to the recovery area or

an intensive care unit (ICU). • Be sure your surgeon knows where

your family will be waiting.• A member of the family may visit

briefly in the recovery or intensive care unit after a few hours of the operation when the patient is awake.

• During the recovery period and beyond, most patients have “goods days” and “bad days” with overall progress and a gain in strength.




CABG Surgery - Frequently Asked

Questions




FAQs• How long does a CABG surgery last? • Coronary artery bypass graft operations

usually last from three to six hours, their duration depending on the number of vessels to be grafted.

• However, each operation varies in complexity, so its duration can only be estimated.

• How long is the convalescent period in the hospital? • Usual stay after surgery – 5-7 days• In case of minimally invasive coronary

bypass surgery (MICAS) – 3-4 days




FAQs• What can be done to help

recovery?• Deep breathing exercises and coughing

are important ways to speed recovery. – Coughing reduces the chances of

pneumonia and fever and will not harm the incision or bypass grafts.

– Most patients will have fear of pain, discomfort and don’t like to cough after an operation, still coughing is essential.

– Some patients find it easier to cough if a pillow supports their chest.

• You can help you own recovery by changing positions in bed often.




FAQs• Will there be pain and fever after

the operation? • The incision made along the midline of the

chest through the breastbone may hurt. • Heavy perspiration during the night or even

the day are often noticed.• Fever may continue for 3-4days after surgery.• Medication will be given to provide relief.

• When can I get out of bed?• Patients may get out of bed and sit in a chair

or walk around the room as soon as they are able – usually within a day or two.

• Eventually, short walks in the hall & stair climbing can prepare you for going home.




FAQs• When can I eat and drink?• Once your breathing tube is removed, you

will be able to swallow liquids. • Your progress from liquids to regular diet is

an individual matter, which depends on your digestive system.

• It is possible you may have a depressed appetite for some days due to mild indigestion caused by stress. This will improve on your return to normal activities.

• Can I have bath?• Patients are given sponge baths right away. It

will be a few days however, before you are allowed to shower and shampoo.




FAQs

• When should routine follow up doctor appointments be scheduled?

• This depends on the patient’s need and the wishes of the cardiovascular surgeon.

• Patients are usually advised about future surgical appointment when they are discharged from the hospital.

• You should see your cardiologist regularly and have lipid profile, TMT & Echo tests at regular intervals to assess progress.

• You should make an appointment with your personal or family doctor soon after returning home.




FAQs

• What can you do to help yourself after returning home?

• There is a lot you can do to help yourself, both before and after your operation, to make sure your operation is successful and that you have smooth and happy recovery period.

— If you smoke, give up smoking— Watch your weight— Watch your cholesterol level— Be positive— Keep physically active— Only take medicines that are prescribed by

your doctor




FAQs

• How long do I have to wait before returning to work?

• If you perform a sedentary job, the average is between three to six weeks.

• If your job involves heavy work, the time is six weeks or longer.

• However, your Doctor is the best guide to help decide when you can return to work.

• What about sexual relations?• Typically patients may resume sexual

relations when they feel like it. • If you have more questions, talk to your

Doctor.




FAQ’S

• Will there be restrictions on driving an automobile?

• You may begin driving any time you feel physically able to operate the vehicle safely.

• It is usually best to wait a few weeks after leaving the hospital to begin driving a car.



Documents

Wockhardt Hospital- Speciality Information Series on CABG Surgery