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Home > Our Services > Conditions and Treatments > Off-pump Coronary Artery Bypass Grafting (CABG)

Off-pump Coronary Artery Bypass Grafting (CABG)





What is it?  


Unlike a traditional Coronary Artery Bypass Surgery, the Off-pump Coronary Artery Bypass Grafting does not require the use of the heart-lung machine. Instead of stopping the heart, surgeons can now hold portions of the heart stabilize during surgery due to technological advances and new kinds of operating equipment. The surgeon can now bypass the blocked artery in a highly controlled and stabilized environment while the rest of the heart continues pumping blood to the rest of the body.


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Why do you need this surgery?


Only certain patients with Coronary Artery Disease can receive this surgery. At present, this procedure can be performed on all the arteries of the heart,


It would ideal for you if you are at an increased risk for complications from the traditional bypass. If you have

  • Heavy aortic calcification
  • Carotid Artery Stenosis
  • Prior Stroke
  • Compromised Pulmonary or renal function



How should you prepare for the surgery?


  • Stop smoking if you are a smoker. You should stop smoking because smoking is a risk factor for coronary heart disease. Your heart disease will not improve if you continue to smoke. It also increases your risk of complications from the surgery.
  • Talk to your doctor or other people who have had the surgery. Knowing what to expect may help reduce your anxiety before the operation.
  • Plan for your care and recovery after the operation. Allow for time to rest, and try to get help for you day-to-day activities.



What happens during the surgery?


  • You will be asked to put on a surgical gown on the morning of your operation
  • General anaesthesia will be given to you and you will be asleep for the entire operation
  • Your breast bone will be divided
  • If more than one artery has to be bypassed, a vein from your leg will be removed and prepared for the additional bypass
  • A stabilizing device is placed on the surface of your hear to limit the motion of the beating heart.
  • The coronary arteries are opened beyond the sites of the blockage, and the open ends of the vein graft are sewn to the openings.
  • Blood flow is then established
  • The heart is effectively "bypassed".
  • Drainage catheters placed around the heart are usually removed after 24 hours.


What are the potential risks or complications?


  • There are always some risks when you have general anaesthesia. Discuss these risks with your doctor
  • There is a risk of infection or bleeding from this operation
  • New blockages can develop in the bypassed vessels. This might require another heart catheterisation and surgery. So it is important to make changes to your lifestyle to decrease the risk of blockage
  • There is a risk of stroke during and after the operation



What happens after the surgery?


  • Temporary pacing wires will be placed to regulate your heart rate and will be removed just before you are discharge
  • You will be recovering in the CCU (Coronary Care Unit) after the surgery where you will receive specialized care and monitoring
  • Usually, you will be transferred to the normal ward the next day.



Home care


  • Have a relative or friend to pick you up on the day of your discharge
  • You will not need nursing at home, but it will be good to have someone help you with your shopping and also to support you for the first 10 days or so
  • Follow up with the pre-arranged check up at the hospital with your doctor
  • Full recovery should take about 3 months

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