Coronary artery bypass grafting (CABG) is a surgery that creates a new pathway for blood to flow around blocked coronary vessels, improving heart function and quality of life. The procedure can be performed using a heart-lung machine (on-pump) or without it (off-pump), and recovery typically takes 6-12 weeks with restrictions on activities and diet. Patients are advised to follow specific post-operative care instructions to prevent complications and improve outcomes.

2. CORONARY ARTERY
BYPASS GRAFTING

3. A form of bypass surgery in which a
healthy blood vessel taken from another
part of the body is used to make a new
path for blood around a blocked
coronary vessel which restores the flow
of blood to the parts of heart.

5.  Restore blood flow to the heart.
 Relieve chest pain & ischemia.
 Improves the patient’s quality of life
Enables the patient to resume a normal
life cycle.
 Lower the risk of a heart attack.

6. CORONARY ARTERY
DISEASE
Disease in the heart major blood
vessels. Usual cause is build up of
plaque which leads to narrowing
of coronary arteries, limiting blood
flow to the heart. LAD is where
most blockages can occur .Extent
of blockage vary from 1%-100%

8. INDICATIONS
LEFT MAIN
ARTERY
DISEASE
TRIPLE VESSEL
DISEASE
ABNORMAL
LEFT
VENTRICULAR
FUNCTION
AFTER ACUTE
MI
FAILED PTCA
OCCLUSION OF
GRAFTS FROM
PREVIOUS CABG

9. Abdominal
Aortic
Aneurysm
Haemorrhage
Diseases
Congenital
Heart
Disease
Pedal
Edema
Valvular Heart
Disease
Uncontrolled
Hypertension
Pregnancy
Uncontrolled
Arrhythmias

10.  Based on the use of HEART LUNG MACHINE
On Pump CABG
It is a time honored procedure that is
performed while the heart is stopped beating , but blood
supply is provided to the rest of the body with the use of
CARDIOPULMONARY BYPASS MACHINE.

11. Off Pump CABG
It is performed WITHOUT the use of
cardiopulmonary bypass machine . This means the heart is
continues to provide blood to the rest of the body by
pumping.

12.  Based on number of Bypasses performed
 Double Bypass
 Triple Bypass
 QdrapleBypas
 Quintuplee Bypass

13.  Patient is brought to the OT room & shift to
the OT table.
 An ANAESTHETIST places IV & Arterial
lines and injects an analgesic.
 An endotracheal tube is inserted and
secured by the anaesthetist and mechanical
ventilation is started.

14.  T he chest is opened via a median
STERNOTOMY and the heart is examined by
the SURGEON.
 Bypass Grafts are harvested-frequent vessels are
•Saphenous veins
•Internal thoracic arteries
•Radial arteries
✓ When harvesting is done, HEPARIN is given to
inhibit blood clotting.

15.  In case of “OFF PUMP” , the surgeon places
devices to stabilize the heart.
 In case of “ON PUMP” , the surgeon places
sutures cannulae into the heart and Instruct the
perfusionist to start CARDIOPULMONARY
BYPASS.
 PROTAMINE is given to reverse the effects
of heparin

16.  Chest tubes are placed in the mediastinal and
pleural space to drain blood from around the
heart and lungs .
 The sternum is wired together and the
incisions are closed by sutures .
 The patient is moved to an ICU to recover.
 After awakening and stabilising in the ICU for
18 to 24 hours and then the patient is shifted to
the cardiac surgery ward .

19. How do I resume my regular activities after
CABG ???

20. Recovery from a CABG procedure takes time
and everyone recovers at a slight different
speed.
AFTER 1 DAY : Able to sit in a chair
AFTER 3 DAYS : Able to walk
: AFTER 5-6 DAYS : Walk up and down stairs
MOSTLY PEOPLE RECOVER WITHIN 12
WEEKS OF THE OPERATION

21. As it takes 6-8 WEEKS to heal your breastbone
YOU have to ease back into your regular
activities slowly .
 The RTA enforces
NO driving for 4-6 weeks

22. DO’S
 Regular Spirometry
 Regular Walking
 Supine Lie Down
 Restrict consumption of Salt (3-5
gms/day)
 Restrict consumption of water (1-
1.5 lts/day)
 Quit smoking and Alcohol
 Keep binding your chest belt for
24 hrs.
 Check your body temperature
 Have regular follow up visits to
doctor
 Take prescribed medicine on time
DONT’S
 Avoid taking bath until
stitches are removed.
 Avoid bending to the floor
 Avoid lifting heavy things
 Avoid consuming fried and
spicy foods
 Don’t operate heavy
machinery for 8-10 weeks.

23.  Bleeding during or after surgery
 Blood clots can cause heart attack,Stroke,
 Infection at incision site
 Pneumonia
 Breathing problems
 Pancreatitis
 Kidney failure
 Arrhythmias

24. PRODUCTS TO CHOOSE
 Fresh vegetable and fresh fruits
 Fresh juices
 Whole wheat
 Whole grain
 High fibers such as(Beans,Broccoli,Berries,Avocados,Apples,
dried fruits ,etc…)
 Oatmeal

25. PRODUCTS TO LIMIT OR AVOID
 Coconut
 Creamy sauced, fried and canned veggies and
fruits
 Bakery products such as (cookies,cakes,white
bread ,etc…)
 High fat snacks

26. Two types of fats, SATURATED &
UNSATURATED FATS
SATURATED FATS it increases the level of
bad cholestrol
Meat piece
Sausages
Butter , ghee , cream,
Coconut oil & palm oil

27.  UNSATURATED FOODS a balanced diet should
still include this , it increases the good cholestrol
& help to reduce blockage in arteries
 Oily fish
 Avocados
 Nuts & seeds
Sunflower , Olive & Vegetable Oil
 Maintain a healthy weight according to
BMI

28. DOYOUR PART, CARE
FORYOUR HEART!