Cardiosurgery: Angina pectoris (heart attack) — Coronary bypass surgery (cabg) . Treatment
Coronary artery bypass grafting (CABG) is one of the most successful surgical treatment methods for the coronary heart disease. The essence of the surgery is to create the vascular collaterals (shunts) feeding the section of the heart muscle suffering from a deficiency of blood circulation. According to statistics of the European clinics, the risk of death during bypass surgery is less than 1%, and the adequacy of blood flow through the shunt in 5 years is maintained in 96% patients.
Coronary artery bypass grafting can solve the problem of myocardial ischemia in the background of angina pectoris and heart attack. The indications for surgery are determined individually, based on the clinical picture and comprehensive examination findings, which includes not only imaging of the coronary arteries’ condition, but also identification of aorta pathology.
Coronary artery bypass grafting is performed under general anesthesia and may be performed in various versions. Selection of the optimal method depends on location of the coronary artery, severity of its narrowing, and general condition of the patient. A thoracic artery is commonly used as the material for shunt creation; in some cases, the collateral is made of a peripheral vein.
- Traditional method involves the use of a cardiopulmonary bypass (CB). Access to the heart is ensured by sternotomy. During surgery, the heart is turned off and the blood is pumped due to vessel connection to CB circuits. The device pushes blood across the small and large circle of blood circulation and maintains the desired temperature.
- The CABG on a beating heart is performed without the use of cardiopulmonary bypass. Immobility of the operated area of the heart is ensured by a special stabilizing device. The advantages of the CABG on a beating heart are substantial reduction of the risk of thromboembolism, pulmonary edema, hypoxic brain injury, and traumatic damage to the blood cells. This technique requires a very high level of professionalism and experience from a physician.
- The minimally invasive technique is an innovative direction in development of CABG operational techniques for affected coronary arteries of the heart anterior surface. Access is provided though a few small incisions without a full dissection of the sternum. The robotic surgical systems can be used during surgery. A minor trauma of such a surgery allows reducing the pain after surgery significantly and greatly reduces the rehabilitation period.
Coronary artery bypass grafting performed subject to availability of indications in a modern cardiology clinic, in most cases, allows counting on a positive result with the possibility of complete or nearly complete rehabilitation.Hide
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