Dr Mukesh Goel
HOD Cardio Thoracic Vascular Surgery,
Asian Institute of Medical Sciences,
Faridabad

Totally Coronary Artery Bypass (CABG) surgery is a modern method to treat coronary heart disease. Total CABG is an advanced form of minimally invasive coronary artery bypass surgery, which is performed without harvesting leg vein. The surgery involves, leg veins which are use to bypass the blocked vessels along with one of the arterial conduits which is normally known as Left Internal Mammary Artery (LIMA). But in total arterial revascularization, we do not use any of the left veins, we use artery in place of artery.

There are four basic arteries, which are available as conduits in the body, one is left internal mammary artery which is routinely used by everybody, other is right internal mammary artery and left hands radial artery and fourth one is gastroepiploic artery. So performing bypass surgery by using all these conduits instead of leg veins is popularly known as total arterial bypass grafting, and is much more complicated, demanding and expensive procedure. But longevity of such procedures, and grafts is very high and the requirement of second or third procedure is very low in these kinds of patients and this is specially offered to young patients and those who are in their early fifties.

It is highly recommended that one should go for total arterial grafting in younger age group. Leg veins, which are commonly used to perform bypass surgery, are made to bear a pressure of 10 to 20 mm of mercury. We put these veins at a place where pressure is much higher, in the coronary artery which is to the tune of 120 to 140 mm of mercury. So by this kind of pressure these conduits, they, degenerate, intima gets thickened and they degenerate within 8 to 10 years because theyre not made to sustain these kinds of pressure. Whereas, arteries are made by nature to sustain a pressure of 120 and 140 mm of mercury so they tend to persist a longer time than the veins.

The advantages of total arterial bypass are no leg vein harvesting and consequently no leg wounds, complications and leg swelling. Not all cardiac surgeons are trained to perform this surgery, only handful of cardiac surgeons can perform it.

Like

Dislike

Be a part of Elets Collaborative Initiatives. Join Us for Upcoming Events and explore business opportunities. Like us on Facebook , connect with us on LinkedIn and follow us on Twitter , Instagram.