Coronary Artery Bypass Grafting (CABG) in Tunisia

Treatment and Cost

22

Total Days
In Country

2 No. Travelers

6 Day in Hospital

16 Days Outside Hospital

Treatment cost starts from

USD 7900

Hospitals

About the Coronary Artery Bypass Grafting (CABG)

What is Coronary Artery Bypass Grafting (CABG)

Coronary artery bypass grafting (CABG) is a type of an open heart surgery that intends to improve the flow of blood to the heart. It involves the placement of a coronary artery bypass graft, which is retrieved from a healthy artery in the body, and placed in the position of the blocked portion of the artery that supplies blood to the heart. CABG surgery is a complex, yet common procedure.

A waxy substance called plaque may deposit in good amount in the coronary arteries of the heart over a period of time. As time advances, the plaque starts hardening and eventually ruptures and breaks open. The plaque interferes with blood flow as arteries grow narrow at the affected region. A blood clot develops when the plaque ruptures. The artery may get blocked completely is the size of the clot is big enough to stop the flow of blood to the heart. This may eventually lead to serious events such as heart attack and also put the individual at the risk of death.

The person may experience chest pain and discomfort when the heart is deprived of rich oxygenated blood This pain is referred to as angina. Breathlessness and  fatigue are some of the other problems associated with coronary heart disease.

How does CABG improve the heart condition

Coronary artery bypass surgery aims at improving the overall blood circulation to the heart. A part of healthy artery or vein from another part of the body is taken and is grafted or connected to the blocked coronary artery for bypass. 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 a single surgery, surgeons can bypass multiple coronary arteries. Severe blockages can be treated with this procedure.

CABG is conducted when there are one or two blockages in the artery. High risk CABG is conducted when there are multiple blockages in the artery and the blood flow to the heart is severely restricted.

How is Coronary Artery Bypass Grafting (CABG) performed?

How is Coronary artery bypass grafting (CABG) performed?

There are two approaches to conduct CABG – open heart surgery and laparoscopic bypass heart surgery. The latter is a type of minimally invasive heart bypass surgery, which involves the creation of smaller incisions. This results in minimum discomfort and complications and allows for faster recovery and healing.

Laparoscopic bypass heart surgery is mostly preferred when there is not much blockage in the coronary artery. Open heart surgery, on the other hand, is conducted in complicated cases. High-risk CABG is mostly conducted as an open heart surgical procedure.

  • The selection of a particular approach, however, depends on a number of factors, including the overall health of the patient and the experience of the surgeon. CABG involves the use of general anaesthesia. Typically, an incision down the middle of the chest is made by the cardiac surgeon. He then uses a saw like instrument to access the breastbone or the sternum. This cutting of the middle of the sternum is referred to as median sternonomy. During CABG, the heart has to be first 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 to the heart during the surgery.
  • A cardiopulmonary bypass must be established before a bypass surgery can take place. To channelize 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 bypass 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 used as coronary artery bypass graft.
  • 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 as a coronary artery 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. The former remains open for a longer period of time. The percentage of being open in the case of venous grafts is around 66 percent, while for internal mammary arteries it is 90 percent.
  • The aorta must be clamped off for 60 minutes while the body is supported by cardiopulmonary bypass. The use of 3, 4 or 5 bypasses has grown very common. At the end of the surgery, the sternum is wired together with the help of stainless steel while the incision made in the chest is sewn. Plastic tubes are kept undisturbed to allow any blood drainage from the region around the heart. The chest tubes are removed right after surgery along with the breathing tube.

Recovery from Coronary Artery Bypass Grafting (CABG)

Coronary artery bypass grafting (CABG) Recovery

Patients are transferred to the ICU right after the surgery and shifted to the patient ward a day later. Heart rhythm disturbances are discovered in 25 percent of the patients within a period of 3 or 4 days after the surgery. They are temporary atrial fibrillations associated with surgical trauma. Such patients respond well to standard medical therapies.

They can be weaned within a period of a month after the surgery. From one week to one day, the range of stay in the hospital may vary from one patient to the other. Young patients are usually discharged within two days. The recovery time can be very long and the range of physical activities must be kept to a minimum.

Patient Stories

Frequently Asked Questions

What is the health care infrastructure of Tunisia / Why should opt for Tunisia as a destination for your medical treatment?
Hospitals in Tunisia are developing and trying to meet the international standards of healthcare. Although there is a basic set up in most of the hospitals for treatment in Tunisia, one can still expect scope for improvement. The Ministry of Health, along with the Government of Tunisia is making effective changes for the healthcare sector. The private hospitals in Tunisia are also undergoing a robust change to provide effective healthcare and treatment in Tunisia.

Like most other countries, hospitals in Tunisia have a private and public healthcare system. Hospitals in Tunisia include three levels of care: primary, with a network of 81 clinics and 2091 basic health centers; secondary, with 109 district hospitals; and tertiary, with 33 regional hospitals and 24 modern CHUs, according to MoS figures.
What are the conditions of the hospitals in Tunisia? 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.
In Tunisia, there are no JCI accredited hospitals but 4 private hospitals are certified ISO and OHSAS (Occupational Health and Safety Assessment Series).
Are the doctors/surgeons in Tunisia of the best quality?
The hospitals in Tunisia have seen a constant change in terms of development and technology. Most doctors that are trained in the country understand the needs and requirements of people and are able to diagnose and treat them well. There are various surgeons that fly in from other countries as well to treat patients. This was brought about due to the economic reforms and various expats residing there. The varying levels of health organizations provide reasonable means of treatment for any patient. There are also trained paramedical and emergency service staff in this country.
What is the process for obtaining a medical visa in Tunisia?
Patients who wish to visit Tunisia for medical purposes must contact the Embassy of Tunisia in their home country. One is required to have a valid passport. Those applicants must submit their visa application forms in person together with the following documents:
  1. A duly completed application form with one picture (within a white background).
  2. Original biometric passport and one copy. Passports should have a validity of at least one year from the date of your visa application submission.
  3. Medical certificate stating the type of illness and the treatment to be carried out. This document has to be in English or Spanish language.
  4. Letter from the hospital in Tunisia stating the appointment date and whether the treatment expenses have been already paid in full.
  5. Proof of financial means which enable the applicant to meet life needs while in Tunisia (salary certificate if working, bank statement for the last six months, property deeds, commercial license, other sorts of income).
  6. Travel insurance.
  7. Proof of accommodation (hotel reservation, etc)
  8. Applicants are advised that ALL PASSPORTS HAVE TO REMAIN at the Embassy premises while the visa application is under process (between 10 and 15 days), and therefore cannot be retrieved unless very special and urgent circumstances might arise.
  9. The Embassy has the right to require from the applicant any document that it may deem relevant in order to resolve the visa file.
What support services does MediGence provide in Tunisia?
MediGence enables you to plan and manage your medical decisions better. These are some of our services offered:
  • Expert Opinion
    We help you seek an Expert Opinion on your diagnosis and treatment from an experienced team of doctors at MediGence and specialists from a reputable hospital.
  • Hospital Recommendation
    We recommend a hospital or a healthcare institution that is best suited for you, based on your ailment and its criticality.
  • 360-degree Hospital Review
    We give you a transparent and holistic view of the hospital and its infrastructure, accreditation, facilities, and expertise to give you confidence.
  • Doctor Validation and Communication
    We share a comprehensive profile of the treating doctor and also arrange a call to clear queries regarding treatment if needed.
  • Options to Choose From
    Based on your choice of destination and other preferences, we provide you multiple options with respect to hospitals and doctors to choose from.
  • 24X7 Patient Care Support
    A dedicated patient case manager stays in constant touch with you to help you at every step of the decision-making process and resolve queries that you may have.
  • Transparent Treatment Cost and Other Expenses
    We give a clear and accurate indication of the total cost of treatment including treatment, stay, meals, and other expenses.
  • Visa Assistance
    We provide and help prepare documentation for visa approval and coordinate with the embassy to expedite the visa process.
  • Accommodation Arrangements
    We propose to you a choice of accommodation based on your preference such as long stay, short stay, or luxury properties.
Which are the best cities in Tunisia for medical treatment?
Tunis is the largest country and capital of Tunisia. This country is located in the northern region of Africa and is the best city for treatment in Tunisia.

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