Coronary artery bypass grafting (CABG) is a type of surgery that is conducted to help blood flow to the heart. Surgeons practice CABG to treat people who have chronic coronary heart disease (CHD).
CHD is a disease in which a waxy substance called plaque deposits inside the coronary arteries. Oxygen and rich blood are supplied to the heart Over time, plaque can harden or rupture. Thick 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.
If the plaque breaks, a blood clot can form on its surface. A large blood clot can mostly or entire block blood flow through a coronary artery. This is the most common cause of a heart attack. Over time, broken plaque also composes and narrows the coronary arteries.
The cardiac surgeon makes an notch down the middle of the chest and then overviews through the breastbone (sternum). This procedure is called a median sternotomy (cutting of the sternum). The heart is cooled with iced salt water, while a preservative solution is to shoot into the heart arteries. This process decreases damage caused by reduced blood flow. Prior bypass surgery can take place, a cardiopulmonary bypass must be created. Plastic tubes are inserted in the right atrium to transfer venous blood out of the body for passage through a plastic sheeting in the heart lung machine. The oxygenated blood is then returned to the body. And the procedure is successful.
Double Valve Replacement
Heart valve surgery reconstructs a injured. There are two main types of heart valve surgeries: valve reconstruct and valve replacement. Double valve surgery is a surgery where dual valves are involved. Sometimes a faulty valve can be repaired by eliminating excess tissue in the cusps of the valve and sewing the edges together. It can be repaired by shrinking or connecting the cords that appears like hinges on the valve. Important rings called ‘prosthetic rings’ or ‘annuloplasty rings’ can also be helpful to narrow an enlarged valve and robust the repair. Another method used to widen a narrowed valve is called ‘balloon valvotomy’. In the valve replacements, the new valve is joined into a rim of tissue that is kept from the original valve.
Advantage: A plus point of valve repair operations is that usually your own valve tissues are used in the reconstruct. If a valve can’t be repaired, it is sometimes eliminated and replaced with a new valve.
Permanent pacemaker implantation
The procedure for a permanent pacemaker does not need open heart surgery, and most people go home within 24 hours.
Prior to the surgery, capsules may be given to make you sleepy and comfortable. Generally, the procedure within the control of local anesthesia.
Steps for pacemaker implantation procedure
During the surgery an ECG and blood pressure monitor will record your heart rate and blood pressure while you lie on the table in the cardiac catheter laboratory. In addition to the conscious sedation, local anaesthetic will be injected beneath the skin in the section of the pacemaker insertion. A 5-10cm slit will then be made beneath the collar bone and a minor pocket under the skin or muscle will be made for the pacemaker battery, and one or more leads will be pushed into a nearby vein so they can be transferred to the heart using x-ray control. The cardiologist will then close the incision with sutures and apply a dressing over the wound.
New pacemaker implants require one nights stay in hospital and the pacemaker is determined by a technician the next day before the discharge.
Biventricular Permanent Pacemaker
In the typical heart, the bottom chambers (ventricles) pump at the similar time and in sync with the heart's higher chambers (atria).
If a person has heart failure, often the right and left ventricles do not pump cooperatively. And when the heart's shrinkage become out of sync, the left ventricle is not able to pump enough blood to the body.
This eventually results increase in heart failure symptoms, such as shortness of breath, dry cough, swelling in the ankles or legs, excess weight gain, continuous urination, fatigue, or irregular heart attack.
Biventricular pacing also called Cardiac resynchronization therapy (CRT), uses a special kind of pacemaker that is designed to help the ventricles sync more normally. It keeps the right and left ventricles pumping cooperatively by sending mini electrical impulses through the leads.
This therapy has been done to help with the symptoms of heart failure with overall quality of life in certain patients with chronic problems that cannot be controlled with tablets and capsules
Here is the step by step guide to the procedure
After getting to the catheterisation laboratory, you'll be asked to sleep on a special table. If the catheter is being inserted between your the abdomen and the upper thigh may be shaved and cleansed with antiseptic fluid.You'll be covered with a sterile cloth and given an injection of local anaesthetic to numb the skin of around your abdomen or arm, so the procedure should not be painful.A small incision will be made in your groin or arm and a fine tube called a sheath is pushed to hold the blood vessel open.The catheter will be passed through your blood vessels and insert your heart using X-ray guidance.A little amount of dye called contrast medium is injected by the catheter and the pressure in your heart will be measured. As the dye is injected, you may feel a hot force sensation that passes quickly. You may also experience a warm sensation in your groin that feels as if you have urinated, or you may have a metallic taste in your tongue. In certain scenarios – let's assume that if your arteries are blocked – your cardiologist may decide to do a surgery with a balloon angioplasty (an interventional procedure to widen blocked arteries). This will be carried out soon after and adds about an additional hour to the procedure. The catheter and sheath will be eliminated once the procedure is complete.If the catheter was injected through your arm, a stiff dressing or cuff may be for a time period of 2 to 3 hours.