Coronary Artery Bypass Graft Surgery or CABG Surgery is an operation which is designed to reroute blood around blocked coronary arteries. Originally, this was made possible in part by development of the heart lung machine that was called a pump. The heart-lung machine is meant to circulate oxygenated blood during the surgical intervention in order to allow cardiac surgeons perform delicate operations on heart which is lying still & is empty of blood. Although CABG procedure successfully restores flow of blood to heart, it is found that some patients emerge with cognitive dysfunction including foggy thought processes & memory loss after the operation. These complications are privately known as ‘pump head’ by the doctors & were initially attributed to heart-lung machine usage.
Advent of Off-Pump CABG Procedure
Technological advances have made it possible for cardiac surgeons to operate upon a beating heart through instruments which stabilize the heart like shunts which re-route blood away from surgical site while at the same time permitting heart to continue with pumping blood along with instruments limiting motion only in areas where the operation is to be performed. This advancement of beating heart bypass surgery however, also gives rise to questions as to whether off-pump CABG procedure is better than coronary bypass surgery performed with help of the heart-lung machine. Studies conducted on the subject however reveal that there is no winner, reinforcing the idea that there are advantages to both on-pump & off-pump CABG procedures.
Off-Pump CABG Surgery
A stabilizer typically immobilizes the portion of the heart with diseased coronary artery during off-pump CABG surgery. Cardiac surgeons then perform the graft while rest of the heart still continues to beat & pump blood all around the body.
Off-Pump CABG Surgery is Safer for High-Risk Cases
Most cardiac surgeons agree that patients who are at great risk for complications from heart-lung machine are most likely to benefit from undergoing off-pump CABG surgery. Moreover, patients who have suffered from a stroke or those patients who are having extensive cholesterol filled deposits in aorta, or the large artery which is carrying blood from heart, are at an increased risk of developing problems with blood & other issues which are associated with use of the heart-lung machine. This includes patients who are very elderly or those having lung disease or poor function of kidneys are also vulnerable. Off-pump CABG surgery make it possible for this category of people without which risk of causing harm would far outweigh benefits of improving blood flow to the heart.
Conventional CABG Procedure
Oxygen-depleted blood in on-pump bypass surgery typically flows from veins into a sophisticated machine which adds oxygen, then filters & warms blood before pumping it back into aorta & subsequently throughout the body. Heart is then clamped off so that the cardiac surgeon can effectively perform operation on a heart which lay still & bloodless.
Cardiac Surgeons Opinions on Off-Pump CABG Procedure
Cardiac surgeons are divided & have differing views on usage of off-pump CABG procedure. Some say that there is no reason to perform off-pump CABG surgery in case the patient is not having any increased risk from the heart-lung machine. Another view of some cardiac surgeons is that off-pump CABG procedure is a better operation which involves lesser bleeding, few blood transfusions, less time on ventilator while the patient also recovers faster. However, off-pump CABG surgery requires special type of expertise & the cardiac surgeon needs committed to it & should have hundreds of off-pump CABG procedures in order to gain expertise.
“Pump Head” Problem Following CABG Surgery
Numerous studies conducted over the past decade indicates that thinking problems & memory loss following coronary bypass surgery can occur in both off-pump & on-pump CABG procedures & is not just restricted to the conventional operation involving the heart-lung machine. However, the main culprit is not yet identified & it is suspected that ‘pump head’ could be the result of trauma from anesthesia, surgery, or pain medications. Nevertheless, good news is that the disturbed cognitive function is found to gradually improve & generally return to normal within a year.
Recommendations for Off-Pump CABG Procedures
It is estimated that more than 145,000 coronary bypass operations are performed in the United States alone every year. Though studies have determined that off-pump CABG procedure does not result in long-lasting results or fewer complications as was expected is comparable to on-pump procedure, but nevertheless superior in high-risk individuals. Moreover, both procedures are remarkably safe in the hands of experienced cardiac surgeons backed by a skilled operation team. It would also be best for the heart patient to leave the decision of choosing the right approach for CABG surgery to the doctors who know best. The patient must therefore find a good cardiologist & a good cardiac surgeon & let them choose if the CABG operation should be performed on-pump or off-pump.
Affordable Heart Bypass Surgery in India
Affordable CABG cost in India is a pleasant surprise for most coronary artery disease international patients, especially when compared to the priced they would need to pay if they avail this procedure in their homeland. Heart bypass surgery in India is of an excellent quality which is at par with the best in the world. In fact many cardiac surgeons in the country are globally reputed & have initially trained & experienced for decades in the United States before returning back to their homeland. Travcure is a globally reputed medical tourism company which is based in India. They are associated with the top cardiac surgeons & the best accredited specialty & multi specialty hospital facilities in the country so as to provide one of the most affordable & hassle-free healthcare journeys to people from all around the world seeking CABG procedures.
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