How much does a coronary artery bypass graft cost?

One of the primary reasons people with coronary artery disease do not seek treatment until it is too late is the cost of a bypass. For uninsured patients in the United States the average cost of a coronary artery bypass graft (CABG) is in the region of $70,000-$120,000. In some states however the price could go as high as $200,000.

Whilst coronary artery bypass surgery is available free-of-charge on the NHS in the UK, it is generally only granted to patients who have a high and impending risk of cardiac arrest. At private hospitals in the United Kingdom a CABG procedure will cost around £20,000 ($28,000).

In Australian, meanwhile, a coronary artery bypass graft costs approximately $32,000.

The cost of coronary artery bypass graft cost abroad

If the cost of treatment at home is proving prohibitive, you may want to consider travelling abroad for a CABG. There are number of internationally-trained cardiology specialist working at accredited hospitals, which specialize in the treatment and care of patients from around the world. Whilst the cost of a CABG abroad is significantly more affordable, the standard of care remains high.

What is the waiting time for a coronary artery bypass graft?

On the NHS in the United Kingdom, the average waiting time for a coronary artery bypass graft is around 4 months – around 200,000 are carried out each year.

In the United States, on the other hand, the waiting time for a bypass graft can vary a lot from state to state, but the average waiting time is somewhere in the region of 3-6 months.

As a coronary artery bypass graft is a potentially urgent procedure, many patients in need of one are now looking at hospitals abroad in an attempt to cut down on waiting times. There are a number of specialist cardiology hospitals around the world offering CABG procedures with reduced waiting time, often at the convenience of the patient.

What is coronary artery disease?

Arteries become narrowed when fatty deposits are left to build, otherwise known as arterial plaque. These deposits cling to the inner wall and if left untreated can reduce the flow of blood through the arteries or block it altogether, the consequences of which can fatal.

cabg - Coronary Artery Bypass

Arterial plaque is caused by a number of factors, most of them a result of lifestyle choices. One of the main contributory factors is the presence of high levels of ‘bad’ cholesterol, otherwise known as low-density lipoprotein. When this bad cholesterol is left to build in the arteries it can lead to blockage. This can be countered by high levels of ‘good’ cholesterol, or high-density lipoprotein, which is able to remove the bad cholesterol from the arteries and ease the blockage. A combination of too much bad cholesterol and not enough good cholesterol to counter it can increase the chances of coronary artery disease.

Nicotine intake and cigarette smoke is another factor which can result in a buildup of arterial plaque. The carbon monoxide which is absorbed through smoking damages the blood cells in the arteries which help the smooth flow of oxygen through the arteries, which subsequently also allows fat and plaque to build up on the artery wall.

Coronary artery disease can also be caused by excessive high blood pressure, which much like nicotine prevents the healthy passage of blood through the arteries and leads to a sustained build up of plaque.

What are the symptoms of coronary artery disease?

There are many signs that coronary artery disease may be developing, but symptoms will not always manifest until the artery is severely blocked.

Early symptoms of coronary artery disease that may occur include chest pain, fatigue, off-beat heart rhythms and palpitations. If you experience any abnormal symptoms at all you should consult a doctor or cardiology specialist, who will be able to determine whether the symptoms are a result of coronary artery disease.

Signs that coronary artery disease is at an advanced stage include swelling or numbness in the extremities (hands and feet) and a severe shortness of breath combined with nausea or sweating.

An electrocardiogram is the one of the methods used to diagnose coronary artery disease, usually alongside CT scans and cardiac catheterization.

How does a coronary artery bypass graft work?

Coronary artery bypass graft (CABG) is a surgery which is used to treat potentially deadly coronary artery disease, which occurs when the coronary arteries become narrow and are no longer able to effectively transport oxygen to the heart muscle. When this happens, the chances of a cardiac arrest increase dramatically and action must be taken to widen the arteries.

If it has been decided that a CABG is needed, there are a number of things to consider when preparing for surgery. Your surgeon will take a number of blood tests to assess whether you are healthy and able to cope with the strain that will be placed upon the cardiac system during and after surgery. If you have a history of bleeding disorders or have problems with blood clotting then you may not be a suitable candidate for a CABG.

angiography

A coronary artery bypass graft (CABG) is performed under general anesthesia, and the procedure begins with the surgeon making an incision from the in the chest which gives access to the sternum. The sternum is then cut to reveal the heart. A number of steps are then taken to reduce blood flow during surgery to prevent damage to the circulatory system. The heart’s main aorta is clamped during surgery to ensure the area is free of blood.

The ‘graft’ part of a coronary artery bypass graft comes from a vein elsewhere in the body – most commonly the saphenous vein in the leg. The surgeon works to remove the graft tissue via a small incision in the leg, and the graft is then attached to the walls of the aorta and the arteries of the chest wall. This essentially allows the blood to ‘bypass’ the blocked arteries and flow freely to the aorta. Multiple bypasses are common, and it is possible to graft up to 5 arteries to the aorta.

Surgery takes around 4 hours, but can take as many as 6 if more grafts are required. The body is supported by an artificial pump for around 90 minutes whilst the heart is stopped, which allows the surgeon to work on the aorta.

Recovery from coronary artery bypass graft

Patients are taken immediately to an intensive care unit after a coronary artery bypass and are kept there overnight for observation. You will then be required to stay in hospital for another 4-7 days as you recover from the procedure.

In most cases a ventilation machine will be used to assist with breathing for the first hours, which is usually passed down the throat. Once you are fully over the effects of the anesthesia and can begin to breathe by yourself to some extent, the machine can be adjusted accordingly. The breathing tube is only removed when you are fully capable of breathing unaided.

It is very important that you frequently cough and take deep breathes in the days following a coronary artery bypass graft. Whilst this may seem peculiar and can cause discomfort, it prevents the build-up of mucus in the lungs and thus reduces the risk of pneumonia developing.

The area of the incision around the chest might also cause discomfort in the days and weeks following surgery. Pain can be eased using medication, but it is vital that any painkillers you take are approved by your cardiologist; this is because traditional painkillers such as aspirin and ibuprofen can increase the chance of a bleed occurring. Drips will be used in the days immediately after the surgery in order to control the level of bleeding and keep your blood pressure stable.

Once you have been cleared to leave the hospital, your recovery will continue at home. Infection is a greater risk that usual with open heart surgery and it is therefore important that you keep the incision area clean and dry. Any pain, swelling or abnormal colour around the incision site should be checked as soon as possible.