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Coronary Artery Bypass(Heart Bypass) Surgery in India

Coronary Artery Bypass

Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG, pronounced “cabbage”)surgery, and colloquially heart bypass or bypass surgery  is a type of surgery that improves blood flow to the heart. Surgeons use CABG to treat people who have severe coronary heart disease (CHD).

CHD is a disease in which a waxy substance called plaque (plak) builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart.

Over time, plaque can harden or rupture (break open). Hardened plaque narrows the coronary arteries and reduces the flow of oxygen-rich blood to the heart. This can cause chest pain or discomfort called angina (an-JI-nuh or AN-juh-nuh).

If the plaque ruptures, a blood clot can form on its surface. A large blood clot can mostly or completely block blood flow through a coronary artery. This is the most common cause of a heart attack. The surgery helps in re-routing blood to the heart muscles, relieving chest pain and improves function of the heart muscles.

Who Should Consider Coronary Artery Bypass Graft Surgery

  • People diagnosed with arterial blockage or heart damage are recommended with the Coronary Artery Bypass Graft Surgery.
  • People suffering from complicated conditions such as diabetes & high blood pressure are recommended the Coronary Artery Bypass Graft Surgery to reduce the risk of heart attack
  • People suffering from severe chest pain or angina due to the arterial blockage are recommended with the Coronary Artery Bypass Graft Surgery.

Which Arteries Are Used for Coronary Grafts?

There are several types of heart bypass grafts. The surgeon decides which graft(s) to use, based on the location of the blockage, the amount of blockage, and the size of the patient’s coronary arteries.

  • Internal mammary arteries: These are the most common bypass grafts used, as they have been shown to have the best long-term results. In most cases, these arteries can be kept intact at their origin since they have their own oxygen-rich blood supply. During the procedure, the arteries are sewn to the coronary artery below the site of blockage. This artery is located in the chest and can be accessed through the primary incision for the heart bypass surgery.
  • Saphenous veins: These veins are removed from your leg, and then sewn from your aorta to the coronary artery below the site of blockage. Minimally invasive saphenous vein removal may be performed and results in less scarring and a faster recovery.
  • Radial artery: There are two arteries in the lower part of the arm, the ulnar and radial arteries. Most people receive adequate blood flow to their arm from the ulnar artery alone and will not have any side effects if the radial artery is removed and used as a graft. Careful preoperative and intraoperative tests determine if the radial artery can be used. If you have certain conditions (such as Raynaud’s, carpal tunnel syndrome, or painful fingers in cold air) you may not be a candidate for this type of bypass graft. The radial artery incision is in your forearm, about 2 inches from your elbow and ending about 1 inch from your wrist. If you have this type of bypass, you may be prescribed a medication called acalcium channel blocker for about six months after surgery to help keep the radial artery open. Some people report numbness in the wrist after surgery. However, long-term sensory loss or numbness is uncommon.
  • The gastroepiploic artery to the stomach and the inferior epigastric artery to the abdominal wall are less commonly used for grafting.

It is common for three or four coronary arteries to be bypassed during surgery

What to Expect After Coronary Artery Bypass Graft Surgery ?

Recovery in the Hospital

After surgery, you’ll typically spend 1 or 2 days in an intensive care unit (ICU). Your heart rate, blood pressure, and oxygen levels will be checked regularly during this time.

An intravenous line (IV) will likely be inserted into a vein in your arm. Through the IV line, you may get medicines to control blood circulation and blood pressure. You also will likely have a tube in your bladder to drain urine and a tube to drain fluid from your chest.

You may receive oxygen therapy (oxygen given through nasal prongs or a mask) and a temporary pacemaker while in the ICU. A pacemaker is a small device that’s placed in the chest or abdomen to help control abnormal heart rhythms.

Your doctor may recommend that you wear compression stockings on your legs as well. These stockings are tight at the ankle and become looser as they go up the leg. This creates gentle pressure up the leg. The pressure keeps blood from pooling and clotting.

While in the ICU, you’ll also have bandages on your chest incision (cut) and on the areas where an artery or vein was removed for grafting.

After you leave the ICU, you’ll be moved to a less intensive care area of the hospital for 3 to 5 days before going home.

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
Lifestyle changes may include making changes to your diet, quitting smoking, doing physical activity regularly, and lowering and managing stress.

Benefits of Coronary Artery Bypass Graft Surgery

Some of the potential benefits of Coronary Bypass Heart Surgery (CABG) include :

  • Lower risk of stroke
  • Lower death rate
  • Less need for transfusion
  • Less heart rhythm problems
  • Less injury to the heart

Procedure for Coronary Bypass Surgery

To bypass the blockage, the surgeon makes a small opening just below the blockage in the diseased coronary artery. If a saphenous (leg) or radial (arm) vein is used, one end is connected to the coronary artery and the other to the aorta. If a mammary artery is used, one end is connected to the coronary artery while the other remains attached to the aorta. The graft is sewn into the opening, redirecting the blood flow around this blockage.
The procedure is repeated until all affected coronary arteries are treated. It is common for three or four coronary arteries to be bypassed during surgery
A Coronary Artery Bypass Graft Surgery (CABG) procedure generally takes 3 to 5 hours but it can vary depending upon the number of arteries that needs to be bypassed

What Is Off-Pump Heart Bypass Surgery?

“Off-pump” or beating heart bypass surgery allows surgeons to perform surgery while the heart is still beating. The heart-lung machine is not used. The surgeon uses advanced operating equipment to stabilize (hold) portions of the heart and bypass the blocked artery. Meanwhile, the rest of the heart keeps pumping and circulating blood to the body.

With present technology, all coronary arteries can be bypassed off-pump. The off-pump technique may be ideal for certain patients who have an increased risk of complications from being placed on the heart-lung machine, such as those who have vascular disease, heavy plaque buildup in the aorta (aortic calcification), carotid artery stenosis (narrowing or blockage in the arteries leading to the brain), prior stroke or transient ischemic attacks (TIAs), or breathing or kidney function problems.

Not all patients are candidates for off-pump surgery. According to the American Heart Association, about 20% of heart bypass surgeries are performed off-pump. The decision to use off-pump surgery is made at the time of surgery when the patient’s heart and arteries can be evaluated more closely.

What Is Minimally Invasive Heart Bypass Surgery?

During minimally invasive heart bypass surgery, the surgeon performs the surgery through a small incision (about 3 inches) in the chest. It may be an option for some patients who require a left internal mammary artery graft to the left anterior descending artery.

Some patients are also candidates for surgery using robotic-assisted techniques, allowing surgeons to perform bypass surgery in a closed chest, beating-heart environment through even smaller incisions.

The benefits of minimally invasive bypass surgery include:

  • A smaller incision, thus a smaller scar
  • A shorter hospital stay; in some cases, only three days are needed (instead of the average five to six days for traditional surgery).
  • Shorter recovery time

Other benefits may include:

  • Less bleeding
  • Less potential for infection
  • Less pain and trauma

Cost Of Coronary Bypass Surgery

India today is most favoured destination for coronary bypass surgery  because hospitals in Inida are equipped with latest technology and doctors are well certified and experienced. This makes the cost of coronary bypass surgery affordable in India as compared to other countries.

Cardiology and Heart Treatment Packages India

Cardiology is a medical Specialty that deals with disorders of the heart. Visit India for the Heart Disease Prevention and Treatment. Alphine life solutions ensure, you get the best Cardiology Treatment Packages, which include diagnosis, treatments in well-known healthcare centers, number of days, operating room and professional fees, medications, state-of-the-art technology. Our 24 x 7 dedicated team provide the patients with expert treatment and care. Our services include cardiac diagnosis and treatments of several heart ailments chest pain treatment, cardiac rehabilitation, Intra Aortic Balloon, Coronary Artery Bypass Graft surgery ,Peripheral Vascular Bypass, Cardiac Rehabilitation, Introducer Sheaths, Heart Valve Replacement, congenital heart defects, coronary artery disease, heart failure, vascular heart disease and Electrophysiology from well certified and experienced team of cardiologists and cardiac surgeons and other assisting staff like technicians and nurses.

Cardiac Care Surgery Packages Procedure Cost (USD) Procedure Cost (INR)
Angiography (Including Non-Ionic Contrast) 330 21750
Angioplasty (Including Non-Ionic Contrast) 4155 253685
Angioplasty with one medicated stent (Cypher) 6560 400800
Coronary Angioplasty (Including Two Stent) 10265 653288
Open Heart Surgery (CABG) 5150 322000
Single Valve Replacement (with St. Jude Valve) 5560 346280
Double Valve Replacement (with 2 St. Jude Valves) 7050 428500
Pediatric Cardiac Surgery – Conduit Repair / ASO/AV Canal Repair / TCPC/Fontan/ASO/AV Canal Repair /TCPC/Fontan 4040 249800
Pediatric Cardiac Surgery – ASD/VSD/AV Repair, MV Repair/Paediatric TOF 4080 251475
EPS 680 41000
EPS & RFA 1540 98560
Pacemaker Implant Single Chamber 4022 248625
Pacemaker Implant Double Chamber 6025 368450
ICD Combo Device Implant 15600 986350
Aortic Valve Replacement AVR or Mitral Valve Replacement MVR (including one valve) 9600 585450
AVR and MVR with two valves 11200 715600
Pacemaker Installation 2600 165800
Cost of the Pacemaker device(depends upon patients condition) 7600 to 18500 464000 to 1052000
Valvuloplasty  2000 121000
RadioFrequency Catheter Ablation Treatment 2650 135820
Robotic Heart Surgery 10800 to 13500 682625  to 825000

Depending on the medical problem and condition of the patient the charges mentioned above may change.. Browse through the Inclusions & Exclusions for details.