Coronary artery bypass grafting is a type of surgical intervention on the heart and coronary arteries. Its essence lies in creating a bypass (collateral) for normal blood flow. Due to narrowing or blockage in the coronary artery, the heart muscle is poorly supplied with blood. Creating an anastomosis using the internal thoracic artery (or great saphenous vein) eliminates myocardial ischemia and angina attacks.
Indications for Surgery
Often, coronary artery bypass grafting competes with the cheaper stenting procedure. However, there are certain cases where it is impossible to prefer the cheaper method:
- Angina of high functional class – the patient is unable to perform even minimal daily activities. For example, walking around the room, eating
- If during coronary angiography at the "Ichilov" clinic, Israel, the specialist diagnosed lesions in three or more coronary arteries of the heart
- If an aneurysm of the heart has previously been identified through various diagnostic studies, accompanied by background disease – atherosclerosis of the coronary arteries
- Simple presence of contraindications to stenting.
Diagnosis
At the leading clinic in Israel, Ichilov, before performing coronary artery bypass grafting, the patient will undergo a series of advanced diagnostic procedures:
- Comprehensive blood laboratory analysis
- Doppler ultrasound of the brain and limb vessels
- Diagnostic coronary angiography
- Stress echocardiography
- Holter monitoring echocardiography.
In addition to collecting medical history, detailed consultations with leading specialists in the field of cardiac surgery and anesthesiology are conducted at the Ichilov clinic.
Procedure of Coronary Artery Bypass Grafting in Israel
The surgical intervention can be performed either on a beating heart or under conditions of artificial circulation. Surgery on a beating heart has several advantages and disadvantages. The advantage of this method is that the risk of postoperative complications is significantly reduced. A disadvantage is that this type of intervention is much more complex than on a non-beating organ. There is an opinion that a beating organ reduces the quality of the collaterals formed by the surgeon. The traditional method of coronary artery bypass grafting involves artificial cardiac arrest by surgeons, connecting the patient to a ventilator and a heart-lung machine. Then, a longitudinal incision is made in the middle and along the chest. During the operation, an anastomosis is created, which is attached below the site of stenosis of the coronary artery. The intervention lasts from 3 to 6 hours. The technique of coronary artery bypass grafting in Israel on a beating heart involves the use of special high-tech stabilizers to reduce heart fluctuations. The minimally invasive technique of coronary artery bypass grafting allows access to the heart through small incisions on the lateral surface of the chest. This enables the entire operation to be performed through intercostal spaces without resorting to rib cutting. The patient is connected to two life support machines after stopping the heart.
Prevention
To avoid complications and the progression of atherosclerosis of the coronary arteries, it is important to adhere to simple rules:
- Quit smoking
- Stay active, engage in physical exercise
- Monitor weight, follow a diet to maintain it in optimal condition
- Develop a habit of eating healthy food.