33510 Coronary artery bypass, vein only; single coronary venous graft

Name of the Procedure:

Coronary Artery Bypass, Vein Only; Single Coronary Venous Graft
(Also known as CABG, Single Vein Coronary Bypass)

Summary

Coronary artery bypass grafting (CABG) is a surgical procedure that uses a vein graft from another part of the patient’s body to bypass a blocked coronary artery. This restores blood flow to the heart muscle.

Purpose

The procedure addresses coronary artery disease (CAD), where coronary arteries become blocked or narrowed due to plaque buildup. The goal is to improve blood flow to the heart, relieve chest pain (angina), and reduce the risk of heart attacks.

Indications

• Severe chest pain due to coronary artery disease
• Blockage of the left main coronary artery or multiple arteries
• Failure of other treatments such as lifestyle changes, medications, or other less invasive procedures

Preparation

• Patients are usually instructed to fast for 8-12 hours before surgery.
• Medications may need adjustment, especially blood thinners.
• Pre-surgery diagnostic tests such as blood tests, electrocardiogram (ECG), and imaging studies like coronary angiography.

Procedure Description

1. The patient is placed under general anesthesia.
2. The surgeon makes an incision in the chest to access the heart.
3. The heart may be temporarily stopped, and a heart-lung machine takes over its function.
4. A vein, often from the leg (saphenous vein), is harvested.
5. One end of the vein graft is attached to the aorta, and the other end is attached to the coronary artery beyond the blockage.
6. Blood flow to the heart is restored, and the chest incision is closed.

Duration

The procedure typically takes 3-6 hours.

Setting

This procedure is performed in a hospital operating room.

Personnel

• Cardiothoracic Surgeon
• Anesthesiologist
• Surgical Nurses
• Perfusionist (who operates the heart-lung machine)
• Operating Room Technicians

Risks and Complications

• Common: Infection, bleeding, arrhythmias
• Rare: Stroke, myocardial infarction, kidney failure
• Complication management includes medications, additional surgeries, or other interventions as necessary.

Benefits

• Improved blood flow to the heart
• Relief from angina
• Increased ability to perform physical activities
• Reduced risk of heart attacks

Recovery

• Hospital stay: 5-7 days, including a few days in the ICU.
• Pain management with medications.
• Gradual return to normal activities over 6-12 weeks.
• Cardiac rehabilitation and follow-up appointments are critical.

Alternatives

• Medication management (beta-blockers, statins, etc.)
• Percutaneous coronary intervention (PCI) such as angioplasty and stenting
• Lifestyle changes (diet, exercise)
• Each has its pros and cons regarding effectiveness, recovery time, and risk profile.

Patient Experience

• The patient will be under general anesthesia and won’t feel anything during surgery.
• Post-surgery, patients might experience pain or discomfort, managed with pain relief medications.
• Initial fatigue and limited physical activity, with gradual improvements over weeks.