One of the most functional surgeries that hugely effects on improving the flow of the blood to the heart is coronary artery bypass grafting (CABG).  It is a kind of surgery that is used to fix the issues relating to the coronary artery disease (CAD)- restriction in the coronary disease-, which is a condition that occurs when the fatty material build-up around the wall of arteries. The result of such accumulation leads to arteries to become too narrow and thus limit the supply of essential nutrients to the heart muscles.

The main reason for performing CABG is to restore blood supply to the heart muscle and more importantly if the doctor notices one or some of the below symptoms, the patients may be the right candidate for CABG:

• Patients exhibit severe chest pain during light exercising, due to the arteries blockage that has made supplying of the blood to the heart muscles difficult.
• The left ventricle- the main pumping chamber of the heart- is not working properly because the patient has more than one malfunctioned coronary disease.
• The patient has a blockage in the left coronary artery.

• At the early stage, patients may not have any visible symptoms, although the disease progression continues until the artery becomes blocked. Patients should take the below symptoms seriously because the decrease of the blood supply to the heart muscle will admittedly increase the chances of a blockage in the coronary artery.
• Fatigue
• Palpitation
• Irregular heart rhythm
• Swelling in the hands and feet
• Having difficulty digesting food

• Enhancing quality of life and decreasing the risk of developing CAD.
• Give patients the freedom to be more active.
• Improving the pumping of the heart.
• Reducing the risk of the heart attack.

• Patients may be required to give a blood sample or any other diagnostic test.
• It is recommended that patients refrain from drinking or eating at least 8 hours before the surgery.
• Patients may be required to wash and cleanse themselves properly.
• Patients should tell their doctors if they are pregnant.

The performance of CABG will be done through two methods. First, an introduction to the general CABG will be given, and afterward, the on-pump procedure and off-pump procedure will be explained

The patient, after removing all the jewelry or any other object, will lie on the back. The patient’s heart rate, blood pressure, breathing, and blood oxygen level will be checked by the anesthesiologist during the surgery. Afterward, the patient will take a sedative to help with the insertion of a berating tube. Following that, using a catheter, the bladder will be emptied. To access the blood vessels to be used for the graft, the doctor will make a small incision either in the legs or wrist and remove the vessels.

To join the graft to the coronary arteries, the doctor will stop the heart temporarily. In order to maintain the pumping of the blood, a tube will be placed in the heart, which is attached to a heart machine. While the patient’s heart is stopped, the doctor will perform the bypass procedure and sew the end section of the vein to the aorta and the other end to the coronary artery. Patients may be needed to have more than one bypass graft which depends on the number of blockages.

To check if the bypass graft is working properly, blood circulation will be guided back to the heart, and the heart will restart using a mild electric shock- if the heart has not already restarted by itself-.

After opening the chest, the doctor will stabilize the artery area using special instruments. Although this procedure does not require a heart-lung bypass machine, an operating person will stand alert in case there is a need for a bypass. After the attachment of the graft to the designated area in the coronary artery and checking its function, the graft will be closed.

At hospitals

While patients are at the hospitals, electrocardiogram ECG tracing, blood pressure, breathing rate, and the oxygen level will be monitored consistently. Patients may need a breathing machine following the surgery to help them with breathing. When the patient is fully awake, the breathing tube will be removed. Furthermore, it is vital that patients try to cough in order to prevent the accumulation of mucus in the lungs. If the surgical site seems to be tender or sore, the doctor will recommend a pain reliever. When the patient’s condition is stable, he or she will be moved out of ICU till full recovery is made.

At home

• It is crucial that patients keep the surgical area clean and dry.
• During the follow-up visit, the doctor will remove sutures.
• Patients are not allowed to drive.
• Taking a bath is allowed only by following your doctor’s instructions.

It is no surprise that CHD and cardiovascular disease CVD are the two leading causes of mortality and disability worldwide. Strikingly, 17.92 million deaths were reported in 2015 due to CVD along with 422.7 million cases of CVD globally, which accounted for nearly one-third of total deaths. Iran has suffered exponential death because of the CVD, and according to researchers, it is one of the significant causes of mortality, morbidity, and disability which accounts for nearly 50% of all deaths per annual. Iran has done an extensive research to shed light on the underlying factors that have a considerable impact on the survival rate of patients even after the CABG.

The finding shows that living a healthy life, specifically maintaining low cholesterol food intake can help patients to live longer. Each year, Iranians doctors signify one aspect of CVD risk factors that have helped patients greatly. As a result, Iran has become a magnet in the Middle East region for treating various heart diseases due to the level of doctor’s expertise and advanced equipment.