Off Pump CABG
During this procedure, the heart is not stopped (no cardioplegia) and heart lung machine is not used. The heart and lungs continue their normal function while CABG is being performed. This is also called Beating Heart CABG. With the heart still beating, CABG requires greater surgical skills and is available at select centers. There are many advantages of off pump CABG namely lower risk of strokes, faster recovery from surgery resulting in shorter ICU and hospital stay. In high risk patients with impaired kidney function, poor heart function or Redo CABG (second time) this surgical technique is better as it provides protection to the heart.
All arterial Grafts
What is very crucial for the long term success of CABG is what is being used as a graft to bypass the blocked coronary artery. Most surgeons use veins from legs for this purpose and this leads to blocked grafts within a few years. But the use of arteries from the chest and hand for bypassing the blocked coronary arteries can help avoid this. This is called All Arterial CABG.
It has been conclusively proven by studies that chest arteries (IMA) have better patency than veins and even drug coated stents. The only problem of All Arterial CABG is that it is technically more demanding and the surgeon needs to be specially trained.
CABG without blood Transfusion
The cell saver machine collects the blood lost during surgery cleans it so that it can be given back to the patient. This eliminates all the risks involved with blood transfusion –HIV, Malaria, Hepatitis etc. In patients with normal haemoglobin, CABG can be performed without blood transfusion using this machine.
CABG with No Touch Aorta technique
The possibility of avoiding the manipulation of the aorta plays a key role in protection of brain in off-pump CABG. Dr Saha has devised a new surgical technique to avoid direct aorta manipulation. This eliminates the risk of stroke after CABG.
MICAS - Minimally Invasive Cardiac Surgery Minimally invasive heart surgery (also called Keyhole Surgery) is performed through small incisions, sometimes using specialized surgical instruments. The incision used for minimally invasive heart surgery is much smaller about 3 to 4 inches. Minimally Invasive Cardiac Surgery (MICAS) or Minimally invasive direct coronary artery bypass graft (MIDCABG)
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