CABG - Redo in Singapore

Treatment and Cost

21

Total Days
In Country

2 No. Travelers

7 Day in Hospital

14 Days Outside Hospital

Treatment Price not available

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About the CABG - Redo

In the United States Coronary artery bypass graft which is a common kind of an open heart surgery if found to be executed in good numbers. Cardiothoracic surgeons are the doctors who are involved in performing the procedure on the concerned patients. This kind of procedure is very appropriate for coronary heart diseases which can become a life-threatening issue later.

About CABG - Redo

Awaxy substance called plaque hets deposited in good amount in the coronary arteries of the heart, they supply oxygen to the heart. With time the plaque starts hardening and eventually ruptures and breaks open. This plaque interferes with blood flow as arteries grow narrow at that region. A blood clot develops when the plaque ruptures open on the surface.  The artery gets blocked if the blood clot developed is very large. This can be the cause of heart attack in a later stage becoming the cause of a life risk.

Symptoms of CABG - Redo

When the heart gets deprived of rich oxygenated blood there is chest pain and discomfort felt by the patient. This pain is referred to as angina. Breathlessness and fatigue are some of the other kinds of problems that are associated with coronary heart disease. In worse case scenario a heart attack which can be life-threatening may affect the patient severely

About CABG - Redo

Coronary artery bypass surgery aims at improving the general blood circulation to the heart. A healthy artery or vein is taken the body and is grafted or connected to the blocked coronary artery for the purpose of bypassing. This artery or vein goes around the blocked portion of the coronary artery and establishes a new path for the blood to flow to the heart thus reducing the chance of a heart attack. In one surgery surgeons can bypass multiple coronary arteries. Severe blockages can be treated with this procedure.

How is CABG - Redo performed?

  • In open heart surgery a general anesthesia is usually involved since it is considered as one of the major surgeries.
  • An incision down the middle of the chest is made by the cardiac surgeon. He then uses a saw like movement to access the breastbone or the sternum. This cutting of the middle of the sternum is referred to as median sternonomy.
  • The heart has to be cooled with iced salt water. Along with this a preservative solution has to be injected in the arteries of the heart. This procedure is referred to as cardioplegia where damage is minimized due to reduced blood flow happening during the surgery.
  • A cardiopulmonary bypass must be established before a bypass surgery can take place.
  • For channelizing venous blood out of the body, plastic tubes must be placed in the right atrium. A membrane oxygenator which is like a plastic sheeting is employed to channelize it to the heart lung machine.
  • The oxygenated blood is then returned to the body. To allow the bypasses to connect with the aorta the main aorta is cross clamped during the surgery. This maintains a bloodless field.
  • Saphenous vein from the leg is the commonly employed vessel for the bypass grafting.
  • Beyond the narrowing of the vessel or the coronary artery, the graft vessel is sewed to the coronary arteries. The other end of the grafted vein or vessel is made to attach with the aorta.
  • Nowadays, chest wall arteries or more specifically the internal mammary artery is used commonly for the purpose of bypass graft. The artery is then separated from the wall of the chest to connect to the left anterior descending artery. It can also be connected to one of the major branches which is beyond the blockage. Internal mammary arteries have an advantage over venous grafts is that it remains open for a longer period of time. The percentage rate of being open in case of venous grafts are 66% while for internal mammary arteries it is 90%. but then artery grafts are of limited lenghth and can hence be only employed to bypass diseases which are located near the proximal or beginning of coronary arteries. The time required in CABG where internal mammary arteries are employed is more since they must be separated from the chest wall. Hence they are not very suitable for emergency cases where blood flow must be quickly resolved to restore the condition of the coronary artery.
  • The aorta must be clamped off for only 60 minites while the body is supported bycardiopulmonary bypass for a period of 90 minutes. The use of 3, 4 or 5 bypasses have grown very common.
  • After the end of the surgery the sternum with the help of stainless steel is wired together while the incision madein the chest is sewn. Plastic tubes are kept undisturbed to allow any blood drainage from the region around the heart.
  • Exploration may be required for 5% f patients within first 24 hours to monitor bleeding after surgery. While chest tubes are removed right after surgery along with the breathing tube.

What are the alternatives for CABG?

The other alternatives for CABG can be balloon surgery or angioplasty which is a less invasive technique but then your cardiologist is the best person to decide which of the surgeries is best suited for  the patient. Percutaneous coronary intervention can also be employed where a stent may be used to keep the artery open. This is also a less invasive technique.

Recovery from CABG - Redo

Aftercare and recovery

The patients are transferred out of ICU right after the day of the surgery. Heart rhythm disturbances are found in 25% patients within a period of 3 or 4 days after the surgery. They are temporary atrial fibrillations which are associated with surgical trauma. They respond well to standard mediacal therapies used. They can be weaned within a period of a month after the surgery. From one week to 1 day, the range of stay in the hospital may vary, Young patients are usually discharged within two days. The recovery time can be very long and the physical activities must be kept minimum.

How long will the effects last?

Unfortunately even after such a major surgery, problems can again come back requiring another surgery where heart blocakges can get detected.

Pros and Cons

Pros
  • Reduces pain or angina and other symptoms of coronary heart diseases
  • One can resume a normal lifestyle
  • the pumping action of heart improves after suffering the damage from a heart attack
  • chances of pumping action improves
Cons
  • Very invasive procedure
  • can be quite expensive and complicated
  • requires quite a lot of preparation before the surgery
  • significant change in lifestyle after surgery

Patient Stories

Frequently Asked Questions

What is the health care infrastructure of Singapore / Why should opt for Singapore as a destination for your medical treatment?
Singapore is generally known for its well-managed health care infrastructure and has an efficient and widespread system of healthcare. Singapore was ranked 6th in the World Health Organization's ranking of the world's health systems in the year 2000. Bloomberg ranked Singapore's healthcare system the most efficient in the world in 2014. Three main healthcare groups exist in Singapore:
  • National Healthcare Group
  • National University Health System
  • SingHealth
The 10 public hospitals in Singapore comprise 8 general hospitals (AH, SGH, NUH, CGH, TTSH, KTPH, NTFGH & SKH), and 2 specialized hospitals (KKH & IMH). In addition, there are 9 national specialty centres for cancer (NCCS & NCIS), cardiac (NHCS & NUHCS), eye (SNEC), skin (NSC), neuroscience (NNI) and dental care (NDCS & NUCOHS). The private healthcare infrastructure in Singapore is also well established. The payment methods include private payment gateways or private insurance companies. You can expect better technology to be used in private hospitals in Singapore. Various procedures like stem cell therapy and cancer research are conducted in Singapore.
What are the conditions of the hospitals in Singapore? Are they JCI certified? What is the quality of the support staff in the hospitals?
The Joint Commission International (JCI) is a global leader in health care accreditation. JCI accreditation is considered a gold standard in worldwide health care. It provides the most skilled and experienced healthcare professionals in the medical industry, as evaluators of the rigorous international standards in healthcare quality and patient safety. Here are some of the JCI certified hospitals in Singapore :
  • Mount Elizabeth Hospital
  • Singapore National Eye Centre
  • National Dental Centre
  • Raffles Hospital
  • National University Hospital
  • Gleneagles Hospital
  • Singapore General Hospital
  • National Heart Centre Singapore
  • Changi General Hospital
  • National Cancer Centre
  • National Skin Centre
  • Johns Hopkins Singapore International Medical Centre
  • Tan Tock Seng Hospital
Are the doctors/surgeons in Singapore of the best quality?
Since Singapore is known all over the world for some of the best medical treatments all across the globe, you can surely expect the best quality of doctors and surgeons here. This country has a very high quality of life and hence the health of people is of high priority.
What is the process for obtaining a medical visa in India?
People who wish to go to Singapore as a tourist for social purposes or seeking medical treatment, and require a longer period of stay beyond the Visit Pass granted on entry into Singapore, may submit an application for extension of stay (not more than 89 days from date of entry) online using the e-Service of ICA. All extension applications must be submitted online using the e-service at least seven days prior to the expiry of the visit pass to avoid overstaying. Extension of visit will not be accepted over the counter. Every visit pass issued to any person as a tourist or for the purpose of a social visit or medical treatment shall be subjected to the condition that the holder shall not engage in any form of employment (paid or unpaid) or in any business, profession or occupation in Singapore during the validity of that pass unless he is a holder of a valid work pass issued under the Employment of Foreign Manpower Act. Do visit the ICA website for further information.
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Which are the best cities in Singapore for medical treatment?
Singapore is a sovereign island city in itself. So you can find many options for treatment in Singapore itself, without having to travel too much.

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