Description

CABG + AVR stands for Coronary Artery Bypass Grafting (CABG) and Aortic Valve Replacement (AVR). This combined procedure is performed to treat both coronary artery disease and aortic valve disease simultaneously. However, it seems you are asking about CABG + AVR without heart valve replacement, which might be a misunderstanding since AVR inherently involves replacing the aortic valve. I’ll provide information on the combined CABG + AVR procedure.

Types of CABG + AVR

1. Traditional CABG + AVR: Both procedures are performed using cardiopulmonary bypass (heart-lung machine).
2. Off-Pump CABG + AVR: CABG is performed without the heart-lung machine, while AVR still requires it.
3. Minimally Invasive CABG + AVR: Uses smaller incisions and specialized instruments to perform both procedures.

Familiarity with Treatment

CABG + AVR is a complex surgery that addresses both blocked coronary arteries and a malfunctioning aortic valve. It is typically performed when both conditions are present and need to be treated simultaneously to improve heart function and patient outcomes.

Procedure

1. Preparation:
   • Preoperative tests such as blood tests, electrocardiograms (ECG), echocardiograms, and coronary angiography.
   • Discussion with the healthcare provider about the procedure, risks, and benefits.
   • Fasting for several hours before the surgery.
2. During the Procedure:
   • Anesthesia: General anesthesia is administered.
   • Incision: A median sternotomy (incision through the breastbone) is made.
   • Cardiopulmonary Bypass: The heart-lung machine is used to take over the function of the heart and lungs.
   • CABG: Healthy blood vessels are taken from other parts of the body (usually the leg or chest) and grafted to bypass the blocked coronary arteries.
   • AVR: The diseased aortic valve is removed and replaced with a mechanical or biological valve.
   • Closure: The incisions are closed with sutures or staples.
3. Duration: The surgery typically takes 4 to 6 hours¹².

Who is it Suitable For?

• Patients with severe coronary artery disease and aortic valve disease.
• Those experiencing symptoms such as chest pain, shortness of breath, and fatigue.
• Patients who are suitable candidates for open-heart surgery.

Who is it Not Suitable For?

• Patients with severe comorbidities that increase surgical risk.
• Those who are not suitable candidates for general anesthesia or cardiopulmonary bypass.
• Patients with conditions that contraindicate open-heart surgery.

Advantages

• Simultaneous treatment of both coronary artery disease and aortic valve disease.
• Improved heart function and symptom relief.
• Reduced need for multiple surgeries and hospitalizations¹².

Complications

• Infection.
• Bleeding.
• Blood clots.
• Stroke.
• Heart attack.
• Kidney failure.
• Complications related to the use of the heart-lung machine¹².

Previous Care

• Regular check-ups and monitoring of heart health.
• Lifestyle changes such as diet, exercise, and smoking cessation.
• Medications to manage cholesterol, blood pressure, and other risk factors.

Aftercare

• Monitoring for signs of complications, such as chest pain, shortness of breath, or infection.
• Pain management with prescribed medications.
• Gradual return to normal activities, avoiding heavy lifting and strenuous exercise initially.
• Follow-up appointments with the healthcare provider to monitor recovery.
• Cardiac rehabilitation to improve heart health and physical fitness.

CABG + AVR is a significant surgical procedure that can greatly improve the quality of life for patients with severe heart conditions.