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In the late 1930s, Dr. John Gibbon performed a cardiopulmonary bypass (CPB) with the help of the heart-lung machine.
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History • In the late 1930s, Dr. John Gibbon performed a cardiopulmonary bypass (CPB) with the help of the heart-lung machine. • In 1953, D. W. Gordon Murray reported placement of arterial grafts in the coronary circulation • In 1955, Sidney Smith was the first to produce saphenous vein and employ it as a graft from aorta to into the myocardium. • In 1958, Longmire performed the first open coronary artery endarterectomy without CPB at University of California at Los Angeles (UCLA).
Continued… • In 1961, Dr. Robert Goetz executed the first human coronary artery bypass operation successfully. • In 1962, Proud fit by visualizing the coronary arteries conducted the first practical cardiac angiography successfully. • In 1964, Kolovos performed the first internal mammary artery-coronary artery anastomosis. • In the 1970s, continued development of technique and conduits took place.
Coronary artery bypass grafting (CABG) refers to a procedure, wherein, the blocked coronary arteries are bypassed with the help of a blood vessel graft in order to restore normal flood flow to the heart. • It alleviates angina, pain and diminishes the associated heart attack risks leading deaths.
The procedure of CABG can be divided into two main stages, that includes Stage 1: the healthy blood vessel (the graft) is removed from body parts like chest wall or leg. Stage 2: The graft is connected to the coronary artery by bypassing the diseased segment- it improves the blood flow to the heart
Latest Developments • A surgical robot is used to perform CABG in a minimally-invasive way- it does not require an incision, decreasing the patient’s recovery period to a few weeks • Keyhole surgery: Much different to the traditional surgical methods, it requires an incision that varies from 2 to 3 inch. • Minimally-invasive surgery and stented angiosplasty in one-Hybrid procedures. • Beating heart bypass or off-pump.
This CABG is performed without the use of a heart-lung machine (cardiopulmonary bypass) In this procedure, the bypass is sewed onto the heart, while the heart keeps on beating. For the surgeon to commence the operation, a wide range of heart stabilizers are used to restrain the heart one section at a time
Advantages of Off-Pump Over on Pump CABG • Lesser need of blood transfusions • Diminished risk of bleeding, stroke and kidney failure. • Patients who are at a risk of health ailments such as lung disease, kidney failure, peripheral vascular disease can greatly benefit from this operation.
Possible risks • Blood clots that may elevate the risks of a stroke, heart attack, or lung problems • Bleeding, infection and difficulty in breathing • Abnormal heart rhythms (arrhythmias) • Pneumonia, Fever and pain
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