Cardiac Surgery

Question 1

What does a Coronary Artery Bypass Graft involve (CABG)

Answer 1

• A surgical procedure used to treat coronary heart disease (CHD)
• Involves bypassing a blocked portion of a coronary artery using another piece of blood vessel
• Can be single or multiple arteries

Question 2

Describe the CABG procedure (8)

Answer 2

1. GA
2. Incision via a Median Sternotomy
3. Traditionally the heart is stopped during surgery and kept going via a cardiopulmonary bypass (CPB) or heart lung bypass machine
4. Less invasive techniques have been developed such as key-hole surgery
5. Cold solution - cardioplegia allows cardiac arrest so surgeon can operate on non-beating bloodless heart
6. The blocked portion of the coronary artery is bypassed with another piece of blood vessel
7. One end of the graft is attached above the blockage and the other below blockage, thus bypassing it to reach the myocardial tissue
8. Takes generally 3-6 hours depending on how many grafts are needed

Question 3

What is the procedure for a valve replacement?

Answer 3

1. Similar approach to a CABG of under a GA, normally via a median sternotomy, with or without the use of CPB
2. Takes 2-4 hours depending on number of valves
3. Incision to the heart is made, allowing the surgeon to see the valve
4. The diseased valve is then removed and the size for the new valve is determined.
5. Once the size has been determined, the valve is stitched to around the annulus and seated into place.
6. Saline is then flushed through the valve to check its competency.
7. The heart is then closed up and patient is then taken off the heart lung machine to restore natural function.