Coronary Artery Bypass Graft Surgery (CABG)

Overview

What is Coronary Artery Bypass Graft Surgery?

Through previous cardiac testing, it has been determined that you have an area of blockage or narrowing in one or more of the coronary arteries that supply blood to your heart muscle. These narrowings are caused by deposits of calcium and fat (plaque) in the artery and can cause damage to the heart muscle if not treated as soon as possible. One way to treat the blocked or narrowed arteries is to bypass the blocked spot with a piece of blood vessel so that blood can reach beyond the blockage. This bypass of the blocked coronary artery can be done by coronary artery bypass surgery.

In order to bypass the blocked coronary artery in this manner, the chest must be opened in the operating room and the heart stopped for a time so that the surgeon can perform the bypass. The patient is asleep during the entire procedure and breathing is done for him/her by a ventilator, a machine that pumps oxygen and air into the lungs through a tube inserted down the throat into the lungs.

In order to open the chest, the breastbone, or sternum, is cut in half and spread apart. Once the heart has been exposed, large tubes are inserted into the heart so that the blood can be pumped through the body during the surgery by a heart-lung machine (cardiopulmonary bypass). The bypass machine is necessary to pump blood because the heart will be stopped and kept still while the surgeon performs the bypass operation.

The blood vessels, or grafts, used for the bypass procedure may be pieces of a vein taken from the legs or an artery in the chest that is rerouted on one end to bypass the blockage. Once the grafts are in place, the tubes to the bypass machine are removed and the heart is restarted. The surgeon will observe the beating heart to make sure that the grafts and the heart are working well. The breastbone is then put back together with wires, and the skin incision is sewn together. The patient is taken to the intensive care unit (ICU) to recover from the surgery.

Reasons for the Procedure

Coronary artery bypass surgery is performed to treat a blockage or narrowing of one or more of the coronary arteries, thus restoring the blood supply to the heart muscle.

Risks of the Procedure

Possible risks associated with coronary artery bypass graft surgery include, but are not limited to, the following:

• bleeding during or after the surgery
• blood clots that can cause heart attack, stroke, or lung problems
• infection at the incision site
• pneumonia
• breathing problems
• kidney failure
• cardiac dysrhythmias
  

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