Currently the trend is towards OPCAB. In our centre we perform 60% of our CABG's by this technique. The major difference is the avoidance of heart lung machine. The heart is a dynamic organ with blood flowing continuously. It is very difficult to perform a bypass on a beating heart. It is indeed technically demanding. But newer technology which is continuing to rapidly evolve in this area is making it possible, simple and safe.

          The device used are called 'Stabilising Systems'. The commonly used one is the 'Octopus System'. They immobilise a small area of the heart at the site where the bypass is to be performed. The bleeding problem is circumvented by the usage of small hollow tubes called shunts which are placed in the artery after opening. The bypass is then constructed in the usual way. The major advantages are the absence of any side effects due to the usage of heart lung machine, lesser hospital stay, quicker recovery and less need for blood transfusion.

          The procedure has its own limitations. It cannot be used in all patients due to various reasons. Our surgeons will discuss with each patient about the feasibility of doing CABG by this technique.


     

1.Octopus stablising system
2. Guidant composite stabilising system

 Risks of CABG :

          The standard risk for the procedure in our centre is 2% comparable to the best in the world. Risk increases with age, female sex, diabetes, previous strokes, poor LV function, diffuse coronary disease and depressed kidney function (Creatinine > 2.0).

          Our surgeons will discuss the risk involved for each patient based on his condition at the time of consultation.


 After CABG :

          CABG is not a curative surgery. It improves symptoms and quality of life by restoring blood flow. Long term benefits depends on a good post surgical program. Every patient after CABG should follow ABCDEF rule :-

                   Aspirin and or/Clopidogrel, ACE inhibitors, Avoid excess alcohol.

                   Beta Blocker

                   Cholesterol control (<100 mg/dl) - Statin therapy

                   Diabetes control (fasting < 90 mg/dl), Diet .

                   Exercise (Preferable to enroll in a "Cardiac Rehabilitation Program" )

                   Follow up

Check with your Cardiologist on the above.