Cardiology is one of the most significant areas of Israeli medicine, where Israeli cardiologists and heart surgeons have received worldwide recognition. This has made clinics in Israel a center of medical tourism for thousands of patients with cardiovascular diseases from all over the world who need urgent heart surgery, including coronary artery bypass grafting – one of the most difficult in cardiac surgery.
Operation Description
Coronary artery bypass grafting (CABG) is essentially the replacement of the coronary vessels involved in the blood supply to the heart muscle. Artificial biocompatible materials can be used as a prosthetic vessel, as well as a part of the vein extracted from the patient himself, most often from the patient’s hip. Creating a bypass means that the damaged vessel is blocked, and alternative blood flow is created bypassing the blocked area.
The operation of coronary artery bypass grafting can be either open with a chest dissection, cardioplegia and connecting the patient to heart-lung machine for artificial circulation, or minimally invasive through small incisions between the ribs. With the invention of high-precision laparoscopic and robotic equipment, such complex cardiac surgeries have become less and less invasive, with minimal rehabilitation time and an extremely low probability of complications. CABG surgery lasts 3-4 hours under general anesthesia.
Indications for coronary artery bypass grafting
Atherosclerosis is one of the main causes of pathological damage to the coronary vessels that supply blood to the myocardium. Fats, cholesterol and calcium accumulate on the walls of arteries and veins, which leads to narrowing of the blood flow lumen or its complete blockage. In addition, the vessels lose their elasticity, narrowing and thereby further reducing the blood supply to the heart. This leads to a myocardial infarction, stroke, or even instant death.
Among the indications for CABG, cardiologists distinguish four main ones::
- coronary artery stenosis;
- significant stenosis of the left artery;
- left ventricular failure;
- simultaneous malfunction of the coronary arteries and valves.
CABG is performed in cases where it is impossible to restore normal blood flow in the coronary vessels with stenting – dilation of a pathologically narrowed lumen using an expanding stent.
Contraindications
Coronary artery bypass grafting is not performed in the presence of serious cardiovascular pathologies.
- Severe diffuse lesion of the coronary artery.
- Reduced left ventricular ejection fraction (LVEF) below 30%.
- Congestive heart failure with pronounced clinical signs.
In addition, like any other surgery, CABG should not be performed in case of kidney failure, cancer, chronic lung diseases, acute forms of infectious diseases, etc.
Coronary artery bypass grafting in Israel
Israeli clinics are equipped with state-of-the-art diagnostic and cardiac surgery equipment, including the Da Vinci robot surgeon. This makes it possible to perform minimally invasive complex operations for coronary artery bypass grafting with minimal risk of complications and a relatively short period of postoperative rehabilitation.
Before the operation, the patient undergoes a comprehensive examination, including:
- electrocardiography (ECG);
- echocardiography (ultrasound of the heart);
- angiography;
- laboratory blood test.
After a complete evaluation, cardiologists collectively decide on the need and possibility of performing coronary artery bypass grafting, and also choose the appropriate method. Clinics in Israel practice all types of CABG, including open surgery, bypass surgery on a beating heart without connecting to heart-lung machine, and minimally invasive robotic surgery. In addition, Israeli clinics have created all the conditions for a comfortable postoperative recovery.