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Coronary Artery Bypass Surgery in India

What is Coronary Artery Bypass Surgery ?

Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG, pronounced "cabbage") surgery, and colloquially heart bypass or bypass surgery, is a surgical procedure consisting of either diverting the left internal thoracic artery (left internal mammary artery or "LIMA") to the left anterior descending (LAD) branch of the left main coronary artery; or a harvested great saphenous vein of the leg, attaching the proximal end to the aorta or one of its major branches, and the distal end to immediately beyond a partially obstructed coronary artery (the "target vessel") - usually a 50% to 99% obstruction. The purpose is to restore normal blood flow to that partially obstructed coronary artery. It is performed to relieve angina unsatisfactorily controlled by maximum tolerated anti-ischemic medication, prevent or relieve left ventricular dysfunction, and/or reduce the risk of death.

Terminology

There are many variations in terminology, in which one or more of "artery", "bypass" or "graft" is left out. The most frequently used acronym for this type of surgery is CABG (pronounced 'cabbage'),pluralized as CABGs (pronounced 'cabbages'). Initially the term aortocoronary bypass (ACB) was more popularly used to describe this procedure. CAGS (coronary artery graft surgery, pronounced phonetically) should not be confused with coronary angiography (CAG).

Number of arteries bypassed

he terms single bypass, double bypass, triple bypass, quadruple bypass and quintuple bypass refer to the number of coronary arteries bypassed in the procedure. In other words, a double bypass means two coronary arteries are bypassed (e.g. the left anterior descending (LAD) coronary artery and right coronary artery (RCA)); a triple bypass means three vessels are bypassed (e.g. LAD, RCA, left circumflex artery (LCX)).

Bypass Surgery


Medical uses

  • Disease of the left main coronary artery (LMCA).
  • Disease of all three coronary vessels (LAD, LCX and RCA).
  • Diffuse disease not amenable to treatment with a PCI.
  • The 2005 ACC/AHA guidelines further state that CABG is the preferred treatment with other high-risk patients such as those with severe ventricular dysfunction (i.e. low ejection fraction), or diabetes mellitus.
  • Peripheral angioplasty refers to the use of a balloon to open a blood vessel outside the coronary arteries. It is commonly done to treat atherosclerotic narrowings of the abdomen, leg and renal arteries caused by peripheral artery disease. Often, peripheral angioplasty is used in conjunction with peripheral stenting and a atherectomy.

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