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to view an animated version of this procedure.
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.
is a disease of the arteries. Cholesterol and fatty deposits build up on the walls of the arteries and restricts blood flow. When the buildup happens in the heart, it may lead to chest pain, called
angina, or a
heart attack. Lifestyle changes and medications 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:
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
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.
Your doctor may also ask you to:
will be given. You will be asleep during the procedure.
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.
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chances of infection such as:
You will have reduced activities during your recovery. A cardiac rehabilitation program will be arranged. You may need to work with a dietitian for a special diet. Recovery may include:
Bypass surgery does not cure heart disease. The grafted blood vessels can also become clogged. You will be encouraged to make healthy lifestyle changes.
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
If you think you have 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 (CABG). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 3, 2012. Accessed September 17, 2012.
Coronary artery bypass graft surgery. Cardio Smart website. Available at:
https://www.cardiosmart.org/Healthwise/hw10/1095/hw101095. Accessed September 17, 2012.
Explore 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: Morone NE, Weiner DK, et al. The impact of pain and depression on recovery after coronary artery bypass grafting.
Last reviewed December 2014 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.
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