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Coronary Artery Bypass Graft (CABG) .

Coronary Artery Bypass Graft (CABG) .

Coronary Artery Bypass Graft (CABG) – Bypass heart surgery is an invasive cardiac surgery procedure to treat coronary artery disease and restore blood flow to the heart. Coronary artery disease may become fatal as it may cause a heart attack or heart failure if not treated in time. Get a cost-effective minimal access CABG ( Bypass heart surgery ) or robotic bypass heart surgery with the best Cardiothoracic- Vascular surgeon in the world at top cardiology hospitals in India. We offer minimal access or less invasive bypass heart surgery (CABG ) as well as robot-assisted bypass heart surgery or coronary artery bypass graft ( CABG ) at the Best heart surgery hospitals in India and abroad. Find cost of coronary artery bypass graft ( CABG ) in India.

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Coronary Artery Bypass Graft(CABG) or Bypass heart surgery :

Bypass heart surgery is an open heart surgery to treat the blocked coronary arteries and avoid a heart attack or heart failure in a coronary artery disease patient. Bypass heart surgery is also called coronary artery bypass graft(CABG ). The Procedure involves taking a blood vessel from another part of the body usually the arteries from the arm or chest or a vein from the legs, and attaching it to the affected coronary artery above and below the narrowed area or blockage. This new blood vessel is known as a graft. Sometimes more than one graft is needed depending on how severe coronary heart disease is and how many of the coronary blood vessels have become narrowed. At CMCS Health, we are associated with the best cardiovascular thoracic surgeons ( heart surgeons ) for cost-effective coronary artery bypass graft(CABG) or bypass heart surgery with the highest success rates. Find coronary artery bypass graft(CABG) in India.

Coronary Artery Disease (CAD) :

Coronary artery disease is a common but life-threatening heart disease. Coronary artery disease occurs when the coronary arteries that supply blood to the heart get narrowed or blocked. Heart tissues and muscles get oxygenated blood through coronary arteries. When coronary arteries get narrowed or blocked the oxygenated blood supply to heart tissues is disrupted and cardiac ischemia occurs. Coronary artery disease occurs over some time. Plaque which consists of fats, cholesterol, and other substances starts accumulating in and on the coronary arteries thereby narrowing the lumen of the arteries. This medical condition is also called atherosclerosis. If the coronary arteries get blocked completely, it may cause a heart attack or even heart failure. Coronary artery disease is the most common heart disease in Europe and other developed countries as well as developing countries.

  • CAD affects almost 1.5 million USA nationals annually and is a leading cause of heart disease-related deaths.
  • Coronary artery disease ( CAD ) accounts for almost 20% rate of mortality in European nationals.
  • Around 20 million coronary artery diseases are estimated in the African region people annually. Lack of awareness and scanty diagnostic facilities are the main causes of heart disease-related deaths in the African population. High blood pressure, diabetes, and modern lifestyles are contributing more to an increase in CAD patients in the African region. 

Signs and symptoms of coronary artery disease:

As coronary artery disease develops over some time, the symptoms do not appear immediately but when the plaque formation inside the coronary arteries is substantial and the blood flow to heart tissues is reduced due to the narrowing of coronary arteries following symptoms are felt by the patients:

  • Angina or chest pain may occur in CAD patients. It is because of the supply of oxygenated blood to heart tissue disruption due to narrowed coronary arteries.
  • Shortness or difficulty in breathing.
  • Unexplained fatigue or tiredness.

If one is above 40 years of age, living a sedentary lifestyle, obese, a smoker, or has a family history of having a heart attack or heart failure, one must see a clinician to rule out coronary artery disease ( CAD ).

Risk factors associated with Coronary artery disease:

Apart from normal aging, other factors which increase the risk of coronary artery disease are:

  • Hypertension or uncontrolled high blood pressure for a long time is an identified risk factor for CAD
  • Smoking is another identified risk factor for developing coronary artery disease
  • Uncontrolled and prolonged elevated blood sugar levels ( diabetes )
  • Living a sedentary lifestyle or being obese
  • High cholesterol levels
  • Getting less than normal sleep ( sleep deprivation )
  • Chronic kidney disease
  • Unresolved and constant stress
  • Unhealthy and imbalanced Diet (too much junk food, saturated fats, and lack of proper nutrition)
  • Metabolic syndrome
  • Chronic alcoholism
  • Obstructive sleep apnea
  • Genetic disorder and family history

Diagnosis of coronary artery disease:

On suspicion of coronary artery disease, the attending clinician will take a brief medical history of the patient and recommend following investigations to confirm the diagnosis of coronary artery disease. 

Blood tests:

Blood tests may be recommended for blood sugar and cholesterol levels. C-reactive protein levels which are indicative of inflammation in coronary arteries are also checked during the blood tests.

Electrocardiogram:

While performing an electrocardiogram sticky patches called electrodes are put on the chest area, arms, and legs. These electrodes are connected to a computer monitor to record the electrical activities of the heart. ECG also notes heart beating patterns. 

Echocardiogram:

An echocardiogram indicates the blood flow pattern to the heart. A weak flow may indicate coronary heart disease or any other heart issues.

Stress Echocardiogram or dobutamine stress Echo:

A stress echo is done while the patient walks on a treadmill or rides a stationary bicycle. Electrodes are connected to the chest area again to record the electrical activities of the heart. A stress echo is done as during the exercise the heart pumps harder and faster than when the patient is doing a daily core routine or doing the echo lying on a bench. If your medical condition does not allow you to walk on a treadmill or ride a stationary bicycle, doctors may decide to inject dobutamine to get the same effect as riding a stationary bicycle or walking on a treadmill. A stress echo will detect the abnormalities which may be missed on a normal echocardiogram or other tests.

Nuclear stress test:

If the stress echo tests come back positive, doctors may recommend more confirmatory Nuclear stress tests. A nuclear stress test helps in diagnosing poor blood flow areas in the heart and any subsequent heart damage or ischemia. A Nuclear stress test shows the flow of blow in the heart during rest and activity. In a Nuclear stress test, a radiotracer ( radioactive material ) is injected by IV and the flow of the radiotracer material through the heart arteries is observed with imaging tests.

Heart CT scan:

A dye is given by IV, and images are taken of the dye passing through the heart's coronary arteries. A Heart CT scan can show deposition of calcium in the heart arteries and narrowing of heart arteries. 

Cardiac catheterization or angiogram: 

When the stress echo shows positive results, clinicians recommend a more confirmatory test called an angiogram or angiography. It clearly shows any blockage and also extent of blockage in the coronary arteries. Depending on this test for narrowed or blocked coronary arteries doctor may recommend a non-invasive cardiac procedure angioplasty or Percutaneous transluminal coronary angioplasty ( PTCA ). PTCA can be performed even during the angiogram or later. If the blockage is in more than three cardiac arteries doctor may recommend a bypass heart surgery or coronary artery bypass graft(CABG).

Coronary Artery bypass graft(CABG) or Bypass heart surgery in India:

Coronary artery bypass graft or bypass heart surgery is also called open heart surgery to treat coronary artery disease. A CABG or bypass heart surgery is performed to restore blood supply to the heart when it is restricted or blocked due to blocked or narrowed coronary arteries and nonsurgical interventions like PTCA are not the choice of treatment. In CABG or bypass heart surgery, a blood vessel usually from the leg or chest is used to create an alternative pathway just below or above the blocked coronary artery to restore proper heart flow to the myocardium. The surgery is performed as a life-saving measure in Coronary artery disease patients either to treat heart attack or to prevent a heart attack. Although the objective of CABG or bypass heart surgery remains the same ( to restore obstructed blood supply to the heart ).

 

Types of coronary artery bypass graft(CABG): 

In India, our expert cardiovascular thoracic surgeons use different variations of CABG to provide a better-suited or tailormade coronary artery bypass graft ( Bypass heart surgery ) to every individual coronary artery disease ( CAD ) patient. Following are variations of coronary artery bypass graft surgeries performed by the best CVTS surgeons in India:

Two main types of Coronary artery bypass graft ( CABG ) are performed either on-pump CABG  or off-pump CABG.

On-pump Coronary artery bypass graft(CABG):

In On-pump coronary artery bypass graft surgery the CVTS doctors perform the CABG by stopping the heart temporarily and using a heart-lung bypass machine to pump the blood. Tubes are put inside the heart and connected to a heart-lung bypass machine. Once the blood is diverted through the heart-lung machine, the surgeon will stop the heartbeats by injecting a cardioplegia solution. A section of the vein ( usually a saphenous vein ) from the leg is used as an alternate pathway for blood flow to heart tissues. The Vein is sewn just below or above the blocked coronary artery.

At times a CAD patient may need more than one graft, depending on the number of blocked coronary arteries and their location. Once all the grafts are put in place, the surgery team will check if the new grafts are working by allowing the blood to flow through them. If the new grafts are found to be working properly, the heart-lung bypass machine is removed, the heart will start pumping the blood on its own, or mild electric shocks may be used to start it again.

Off-pump coronary artery bypass graft(CABG) :

Off-pump coronary artery bypass graft surgery is performed on a beating heart. It means the surgery will be performed by not stopping the heart and the heart will be pumping blood to the body even during the coronary artery bypass graft surgery. A team of doctors with a heart-lung bypass machine will be kept on standby mode just in case the surgery needs to be completed on-pump. The rest of the surgical procedure will remain the same.

Off-pump bypass heart surgery is not for every patient as it is a more complex surgery. Some of our expert CVTS surgeons in India are specially trained and have plenty of experience in performing off-pump bypass heart surgery with success.

Other variations of coronary artery bypass graft(CABG) surgery:

Our expert CVTS surgeons in India are also performing these types of coronary artery bypass graft (CABG) surgeries for better patient compliance and with at-par success rates as compared to the best heart surgery hospitals in the world:

Minimal access coronary artery bypass graft(CABG) surgery:

Although not every coronary artery disease patient needing a CABG is the right candidate for a minimal access CABG but still minimal access CABG is one of the most preferred variants of CABG. In conventional open bypass heart surgery, the CVTS surgeon will cut down the center of the chest from just above the breast bone to the end of the chest cage. The CVTS surgeon will cut the breast bone ( sternum) in half lengthwise. They will spread the two halves of the breastbone and lift the chest cage to have better access to the heart to put the coronary artery bypass grafts ( Usually from the saphenous vein in the leg), just below or above the blocked coronary artery. The open bypass heart surgery requires a big incision down the middle of the chest. Whereas with minimal access to CABG, the CVTS surgeon will not make a big incision and splitting and lifting of the sternum and ribcage, rather he will make several smaller incisions and access the heart through the gaps between the ribs. The minimal access bypass heart surgery is usually done Off-pump or on a beating heart. We are associated with top heart surgery hospitals in India for cost-effective minimal access coronary artery bypass graft surgery for our global patients.

Advantages of minimal access coronary artery bypass graft(CABG):

  • Patients who underwent minimal access to CABG will have to endure less pain as compared to open-bypass heart surgery
  • Less scarring and improved cosmetic results 
  • Faster recovery 
  • Lower complications risk post the minimal access CABG
  • Shorter duration of hospital stay

Robot-assisted coronary artery bypass graft(CABG) surgery:

Robot-assisted bypass heart surgery is a relatively new surgical procedure for performing the complex coronary artery bypass graft ( CABG ). Robot-assisted CABG surgery is a minimally invasive alternative to conventional open-bypass heart surgery. Robotic coronary artery bypass graft surgery is performed in selective heart surgery hospitals by specially trained CVTS surgeons. In robotic bypass heart surgery, special surgical instruments and a high-resolution camera are attached to the arm of a robot. The robotic arms are controlled by a specially trained CVTS surgeon through a computer console. 

Selection of a coronary artery disease patient for a robot-assisted CABG or conventional open heart surgery depends on the severity of coronary artery disease, its location, history of any previous surgery as well as other medical conditions. 

Process of robot-assisted CABG:

Robotic bypass heart surgery is performed under general anesthesia. The specially trained and expert CVTS surgeon will make three small incisions on the left side of the chest wall. Specially designed thin surgical instruments with a robotic arm and a specialized camera also attached to a robotic arm are then placed through these small incisions. The Robotic surgery-trained Cardiovascular thoracic surgeon performs the surgery by controlling these surgical instruments and the camera attached to a specialized computer console. The specialized computer console provides a clear, three-dimensional view of the surgical field within the chest. In the majority of robotic bypass heart surgery, the left internal mammary artery is harvested using the thin robotic arms. The left internal mammary artery is then connected to the blocked coronary artery either through the three small incisions already made on the left side of the chest or through a separate incision made on the front of the chest. After performing the CABG surgery, the surgery team will remove the instruments and close the incisions.

Advantages of Robotic coronary artery bypass graft ( CABG ) Surgery: 

Although slightly more costly than conventional open bypass heart surgery, the robot-assisted CABG has distinct advantages. 

  • Smaller incisions made during a robot-assisted CABG reduce the duration of stay in hospital post the surgery, early recovery, and faster return to work and daily core activities.
  • Improved precision and flexibility in the range of motions of the surgical instruments 
  • Because being minimally invasive, the robotic CABG results in less scarring and better cosmetic outcome
  • Reduced risk of surgical complications like infections or bleeding
  • The patient has to endure less pain during the recovery process

The Hybrid CABG procedure:

The hybrid CABG procedure involves robotic CABG on either one of the blocked arteries and noninvasive CABG procedures like PTCA ( percutaneous transluminal coronary angioplasty ) or putting the stent for the remaining coronary arteries.

At CMCS Health, we are associated with the top cardiovascular thoracic ( heart ) surgeons in the world for cost-effective CABG or bypass heart surgery at the best heart surgery hospitals in India and abroad.

Coronary artery bypass graft(CABG) cost or Bypass heart surgery:

The cost of coronary artery bypass graft ( CABG ) or bypass heart surgery depends on the number of blocked or narrowed coronary arteries, the type of procedure, and the overall hospital stay of the procedure. Being a complex and big surgery, the stay period in the intensive care unit and overall hospital stay may increase beyond the estimated time for some patients because of complications. This may raise the cost of CABG or bypass heart surgery. The generalized cost of bypass heart surgery or CABG is as follows:

Coronary artery bypass graft(CABG) cost in India:

Cost of workup investigations ( Including blood tests and angiogram) In USD      300 - 500 USD
 Cost of coronary artery bypass graft ( CABG) or bypass heart surgery         4500 - 6000 USD
 Cost of endoscopic saphenous vein harvesting    500 USD
 Cost of Robotic coronary artery bypass graft (CABG) or bypass heart surgery        6500 - 7500 USD

 

The cost of the coronary artery bypass graft surgery  ( CABG ) package includes the fee of the surgeons, 2-3 days ICU stay, and 5 - 6 days twin sharing room stay post-surgery.

Please note that any extra stay in hospital than the package period due to any complication will be charged extra.

Cost of coronary artery bypass graft ( CABG ) in Singapore:

Cost of workup investigations ( Including blood tests, imaging tests, and angiography) in USD                 4000- 5000 USD
Cost of Coronary artery bypass graft ( CABG ) in USD                15000 - 45000 USD

 

The cost of CABG in the best Singapore hospitals covers the surgical procedure, anesthesia, hospital stay, post-operative care, and other medical expenses. The cost of coronary artery bypass graft ( CABG ) in Singapore depends on the type of surgery, the expertise of the CVTS surgeon, and the location of the hospital.

The cost of coronary artery bypass graft (CABG) in Turkey :

The average cost of coronary artery bypass graft ( CABG ) in the best heart surgery hospitals in Turkey depends on the type of surgery, the expertise of the doctor, and the hospital. 

The average cost of coronary artery bypass graft ( CABG ) in Turkey
The average cost of CABG in the best turkey heart surgery Hospitals in Turkey in USD             Apporox - 40'000 USD

 

The top heart surgery hospitals for coronary artery bypass graft(CABG) or bypass heart surgery in India:

Most the the top heart surgery or cardiac hospitals in India are well-equipped and well-managed with a very good success rate that matches with the best heart surgery hospitals in the world. The lowest cost, the expertise of Indian cardiovascular thoracic surgeons, modern and well-equipped operation theaters, ultramodern diagnostic facilities, the latest technologies, and almost no waiting period have made India a preferred destination for Global guests seeking coronary artery bypass graft ( CABG ) in the world. The 10 topmost JCI and NABH-accredited heart surgery hospitals in India are:

  1. Medanta - The Medicity Hospital, Gurugram, India.
  2. Fortis Memorial Research Institute, Gurugram, India.
  3. Manipal Hospital, Dwarka, New Delhi, India.
  4. Indraprastha Apollo Hospital, New Delhi, India.
  5. Max super-specialty Hospital, Saket, New Delhi, India.
  6. MGM Healthcare, Chennai, India.
  7. KIMS Hospital, Hyderabad, India.
  8. Narayana Hospital, Bengaluru, India.
  9. Fortis Escorts Heart Institute, New Delhi, India.
  10. Asian Heart Institute, Mumbai, India.

Top Heart surgery Hospitals for coronary artery bypass graft ( CABG ) in Singapore:

  1. National Heart Center, Singapore.
  2. National University Heart Center, Singapore ( NUHCS )
  3. Mount Elizabeth Hospital, Singapore.
  4. Khoo Tech Puat Hospital, Singapore.
  5. Mount Elizabeth Hospital, Singapore.

Top Heart surgery Hospitals for coronary artery bypass graft in Turkey:

The best coronary artery bypass graft (CABG) hospitals in Turkey are :

  1. Medical Center, Istanbul Turkey.
  2. Acibadem Hospital, Istanbul, Tutkey.
  3. Memorial Hospital, Istanbul, Turkey.
  4. KOC University Hospital, Istanbul, Turkey.

The Best CVTS Surgeons in India for CABG heart Surgery:

At CMCS Health, we are associated with the best CVTS surgeons for cost-effective bypass heart surgery or coronary artery bypass graft (CABG) for Indian and global medical travelers. As your Global healthcare guardians, we offer you CABG with the best heart surgeons or CABG specialist doctors. The best heart surgery doctors in India are:

  1. Dr. Yugal Mishra, Manipal Hospital, New Delhi.
  2. Dr. Anil Bhan, Medanta - The Medicity Hospital, Gurugram, India.
  3. Dr. Z.S. Meherwal , Fortis excorts heart institute, New Delhi, India.
  4. Dr. Naresh Trehan, Medanta - The Medicity Hospital, Gurugram.
  5. Dr. Sandeep Attawar, KIMS Hospital, Hyderabad, India.
  6. Dr Devi Shetty, Narayan Hospital, Bengaluru, India.
  7. Dr. Bhabha Nanda Dass, Indraprastha Apollo Hospital, New Delhi.
  8. Dr. Udgeath Dhir, Fortis Memorial Research Institute, Gurugram, India.
  9. Dr. Rajnessh Malhotra, Max Suoer-specialty Hospital, New Delhi, India.
  10. Dr. Suresh V. Joshi, Nanawati Max super-specialty Hospital, Mumbai, India.

Frequently Asked Questions about coronary artery bypass graft (CABG) or bypass heart surgery:

Once a coronary artery disease ( CAD ) patient is advised to undergo a bypass heart surgery or coronary artery bypass graft ( CABG ), they have many doubts and questions to ask. CMCS Health is a committed global healthcare guardian for medical travelers seeking coronary artery bypass graft ( CABG ) with the best heart surgery specialists in the world. If any patients need any clarification about the bypass heart surgery or CABG, we can offer them a video conference call with the top CABG specialist doctors. The most frequently asked questions about a CABG surgery or as follows:

Why do I need a coronary artery bypass graft (CABG) or bypass heart surgery?

If you have been diagnosed with a coronary artery disease ( CAD ) that can not be treated with medications or coronary angioplasty ( putting stents in narrowed or blocked heart coronary arteries ), have suffered a heart attack, or are at a higher risk of a heart attack, your doctors may advise you to undergo a CABG surgery.

How to choose the best CVTS surgeon and a heart surgery hospital for my CABG?

You need to email us all your medical reports including a brief medical history ( including age, gender, and comorbid factors like diabetes or any other health issue), your echocardiogram or stress echo report, your angiography CD, and a recommendation of treatment from your local treating doctor. Once we receive them, we discuss your case with the leading cardiology surgeon ( CVTS ), find out all the treatment options and costs of treatment, and your hospital and India stay needed. We will do the spadework for you and inform you about the treatment opinions and expertise of the leading coronary artery bypass graft surgeons. As your global healthcare guardian, we help you in choosing the best doctor and hospital that best caters to your needs and budget.

How will I come to India for my CABG treatment?

After receiving the opinions and performance invoice for the treatment cost from the leading CABG specialist doctors and choosing the hospital and surgeon, you will need a medical visa to come to India. We will need the passport details of you and your companion ( medical attendant ) to help you with a visa assistance letter from your treating hospital in India for applying for a medical visa for yourself and a medical -X visa for your medical attendant. We will shoot an email to the Indian embassy or Indian visa consulate to issue you a medical visa. You will need to apply online for a medical visa on behalf of this visa assistance letter. In many countries now E-visa facilities are available for Indian medical visas. Once you get the medical visas book your air ticket and send us your travel itinerary, we will schedule your appointment with your treating doctor in India and arrange for your pickup from the Airport. We will arrange a budget hotel room or a guest house room with a furnished kitchen as per your needs and budget in a safe and secure environment and in the vicinity of your treatment hospital. 

How soon my treatment will start after reaching India?

We have already scheduled your appointment with your chosen treating doctor in India, so you will see your treating doctor immediately after reaching India. Your treatment will start ASAP after reaching India. Your treating doctor may advise some workup tests for you before giving the coronary artery surgery date. Our patient care executives will help you in every aspect of your medical treatment and India stay.

How will I know about the best type of coronary artery bypass graft surgery for me?

Our associated best coronary artery bypass graft surgery specialist doctors are performing the latest types of CABG surgeries and their variations with matching success rates among the best CVTS surgeons in the world. Once your chosen CVTS surgeon examines you physically and after closely observing the workup investigation reports he ordered earlier, he will discuss the types of CABG surgery best suited to your medical needs. Your treating doctor will help you choose a tailor-made and best-suited type of CABG surgery for your medical needs and budget.

What will be my hospital stay duration for my bypass heart surgery?

The usual hospital stay post a successful coronary artery bypass graft surgery is for 8 days, out of which there will be 2 - 3 days in the cardiac ICU. Patients are generally discharged from the hospital after 8 - 9 days. If any complication arises the hospital stay may be prolonged.

For how long i will be staying in India post my successful CABG?

Your treating clinician will advise a minimum of three weeks stay post-discharge from the hospital after the CABG surgery for observation and cardiac rehabilitation. Once he is fully convinced that your CABG surgery is successful and now you can safely return to your home country, he will prescribe some medications and tell you certain dos and do-nots after reaching your home country, you will also be given a follow-up plan to keep a tab on your progress.

Will I need to come back to India for a follow-up?

Usually one does not need to come back to India after a successful CABG surgery. One can be evaluated by the local treating doctors for follow-ups. In case of any complication or clarification, the patient can avail of a video consultation with his surgeon by paying the consultancy fee of the doctor.

 

If one still has a doubt or further clarification is needed, our dedicated patient welfare executives can be contacted through WhatsApp to resolve any issues. We are committed to the well-being of our patients and strive to provide our best services for a good experience for our patients.