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A coronary artery bypass graft (CABG) is a surgery to restore blood flow to the heart muscle. This is done by using blood vessels from other parts of the body to make a new route for blood to flow around blocked coronary (heart) arteries.
Atherosclerosis is a disease of the arteries. Cholesterol and fatty deposits build up on the walls of the arteries. This restricts blood flow. When the buildup happens in the heart, it may lead to chest pain, called angina, or heart attack. Lifestyle changes and medicines can be used to treat atherosclerosis. When the blockage gets too severe, CABG is done to re-establish blood supply to the heart muscle. It is often recommended in cases of:
If you are planning to have a CABG, your doctor will review a list of possible complications, which may include:
Some factors that may increase the risk of complications include:
Your doctor will likely do the following:
Talk to your doctor about your medication. You may need to stop taking certain medication for one week before surgery, such as:
Your doctor may also ask you to:
General anesthesia will be given. You will be asleep during the procedure.
A breathing tube will be placed in your throat. Next, an incision will be made through the skin. The breastbone will be split to open the chest. A heart-lung machine will be connected. Since the heart needs to be stopped for the surgery, this machine will act as the heart and lungs.
An artery will be taken from the chest wall. Or, a section of vein will be removed from the leg. This section will be used as the bypass. Once the heart is stopped, the new vessels will be connected (grafted) to the blocked arteries. One end will be attached just above the blockage. The other end will be attached just below the blockage. When the grafts are in place, the heart will be allowed to "wake up." Electrical shocks may be needed in some cases to regulate the heart’s rhythm. The heart-lung machine will be disconnected. Temporary tubes may be placed in your chest to help drain any fluid. The breastbone will be wired together. The chest will be closed with stitches or staples.
There is a less invasive approach, called minimally invasive coronary artery surgery. The purpose of this surgery is the same, but the technique and condition of the patient are different. Patients who have only one or two clogged arteries may be candidates for this approach. In this technique, a small incision is made in the chest. The doctor usually uses an artery from inside the chest for the bypass. The key difference in this technique is that the doctor performs the surgery while the heart is beating. With this technique, the heart-lung machine is not needed. If you need CABG, your doctor will carefully evaluate you to determine the best technique for you.
You will be monitored in the intensive care unit, where you will have the following interventions:
Anesthesia prevents pain during surgery. You may be given medication for any pain during recovery.
When you return home, do the following to help ensure a smooth recovery:
Note: Bypass surgery does not cure heart disease. The grafted blood vessels can also become clogged. You will be encouraged to make healthy lifestyle changes.
In case of an emergency, call for medical help right away.
American Heart Association
National Heart, Lung, and Blood Institute
Heart and Stroke Foundation of Canada
Coronary artery bypass graft surgery (CABG). Cardio Smart website. Available at: http://cardiosmart.org/heartdisease/ctt.aspx?id=900. Accessed September 17, 2012.
What is coronary artery bypass grafting? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/cabg/. Updated February 23, 2012. Accessed September 17, 2012.
12/3/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Morone NE, Weiner DK, Belnap BH, et al. The impact of pain and depression on recovery after coronary artery bypass grafting. Psychosom Med. 2010;72:620-625.
Last reviewed December 2013 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.