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'''Coronary artery bypass grafting''' (CABG, often pronounced "cabbage") is a surgical procedure that improves blood flow to the heart. Surgeons use CABG to treat people who have severe coronary heart disease (CHD). CHD is a disease in which a waxy substance called plaque (plak) builds up inside the coronary arteries. These arteries supply oxygen-rich blood to your heart.
[[File:Coronary artery bypass surgery Image 657B-PH.jpg|thumb|Coronary artery bypass surgery Image 657B-PH]]
'''Coronary artery bypass grafting''' ('''CABG''', often pronounced "cabbage") is a common [[cardiac surgery|surgical procedure]] used to improve [[blood flow]] to the [[heart]]. It is primarily indicated for individuals with severe [[coronary artery disease]] (CAD), also known as coronary heart disease (CHD), in which a waxy substance called [[plaque]] builds up inside the [[coronary arteries]]. These arteries supply oxygen-rich blood to the heart muscle.


Contents
== Procedure ==
1 Procedure
CABG is performed by using a healthy [[blood vessel]] from another part of the body—commonly the [[saphenous vein]] from the leg, the [[radial artery]] from the arm, or the [[internal thoracic artery]] from the chest wall—to bypass blocked or narrowed segments of the coronary arteries. This newly grafted vessel creates an alternate route for blood to reach the heart muscle, thereby restoring adequate blood supply and oxygenation.
2 Indications
 
3 Risks
The surgery is typically done under [[general anesthesia]], and the heart may be stopped temporarily using a [[cardiopulmonary bypass machine]], or performed "off-pump" while the heart is still beating.
4 Recovery and Rehabilitation
 
5 Outcomes
== Indications ==
6 See also
CABG is indicated in several clinical scenarios, including:
7 References
* Severe [[multi-vessel coronary artery disease]]
8 External links
* Significant blockage of the [[left main coronary artery]]
[[File:Coronary artery bypass surgery Image 657B-PH.jpg|thumb|Coronary artery bypass surgery Image 657B-PH]]
* Intractable [[angina]] (chest pain) unresponsive to [[medical therapy]]
* Failed [[percutaneous coronary intervention]] (PCI), such as [[angioplasty]]
* Reduced [[left ventricular ejection fraction]] with viable myocardium
* Presence of concomitant conditions such as [[diabetes mellitus]] or [[heart failure]]


==Procedure==
== Risks ==
Coronary artery bypass grafting (CABG) is a surgical procedure performed to bypass the narrowed or blocked sections of the coronary arteries, thereby restoring blood flow to the heart. This procedure involves the use of a healthy blood vessel, typically harvested from the leg, arm, or chest, to create a new pathway for blood to flow around the obstructed coronary artery.<ref>{{Cite book |last=Mann |first=DL |title=Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine |publisher=Saunders Elsevier |location=Philadelphia |year=2015 |isbn=1-4557-5133-9}}</ref>
Like all major surgeries, CABG carries certain risks and potential complications, including:
* [[Infection]] at the incision or graft site
* [[Bleeding]]
* [[Arrhythmia]] (especially [[atrial fibrillation]])
* [[Stroke]]
* [[Myocardial infarction]] (heart attack)
* [[Kidney failure]]
* [[Lung complications]] or respiratory failure


==Indications==
The risks are elevated in patients with multiple comorbidities, advanced age, or poor baseline [[cardiac function]].
CABG is primarily indicated in patients with severe coronary heart disease, particularly those with high-grade stenosis of the left main coronary artery or severe multi-vessel disease. It may also be considered in individuals experiencing angina or heart failure symptoms that are not adequately controlled with medication or less invasive treatment options.<ref>{{Cite journal |last=Fihn |first=SD |title=2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease |journal=Journal of the American College of Cardiology |volume=60 |issue=24 |pages=e44-e164 |year=2012 |doi=10.1016/j.jacc.2012.07.013}}</ref>


==Risks==
== Recovery and Rehabilitation ==
As with any surgical procedure, CABG carries risks, which may include infection, bleeding, arrhythmias, stroke, or myocardial infarction. The risk of complications is higher in certain populations, such as the elderly, those with poor heart function, and those with comorbid conditions like diabetes or kidney disease.<ref>{{Cite journal |last=Hillis |first=LD |title=2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery |journal=Journal of the American College of Cardiology |volume=58 |issue=24 |pages=e123-e210 |year=2011 |doi=10.1016/j.jacc.2011.08.009}}</ref>
Recovery after CABG typically involves:
* 5 to 7 days of hospitalization, including time in an intensive care or cardiac unit
* Gradual return to daily activities over 6 to 12 weeks
* Participation in a structured [[cardiac rehabilitation]] program, including supervised exercise, dietary counseling, and education about cardiovascular risk reduction


==Recovery and Rehabilitation==
Wound care, medication adherence, and emotional support are important parts of the recovery process.
Recovery from CABG surgery involves a stay in the hospital for about a week, followed by several weeks of rest and gradual increase in physical activity at home. Cardiac rehabilitation, a program of exercise and education designed to help patients recover from heart surgery and prevent future cardiac events, is often recommended following CABG.<ref>{{Cite journal |last=Balady |first=GJ |title=Core Components of Cardiac Rehabilitation/Secondary Prevention Programs: 2007 Update |journal=Circulation |volume=115 |issue=20 |pages=2675-2682 |year=2007 |doi=10.1161/CIRCULATIONAHA.106.180945}}</ref>


==Outcomes==
== Outcomes ==
CABG has been shown to improve symptoms of coronary heart disease, such as angina, and improve survival in certain groups of patients, particularly those with severe disease. However, the benefits of the surgery must be weighed against the risks, and long-term success is dependent on adherence to lifestyle modifications and medical therapy to prevent progression of coronary artery disease.<ref>{{Cite journal|last=Weintraub|first=WS|title=Comparative effectiveness of revascularization strategies|journal=The New England Journal of Medicine|volume=366|issue=16|pages=1467-1476|year=2012|doi=10.1056/NEJMoa1111689}}</ref>
CABG is highly effective in relieving symptoms of coronary artery disease, especially [[angina pectoris]], and can improve quality of life and longevity in appropriately selected patients. Long-term success depends on:
* Lifestyle modification ([[smoking cessation]], [[exercise]], [[dietary changes]])
* Control of risk factors like [[hypertension]], [[hyperlipidemia]], and [[diabetes]]
* Adherence to prescribed [[cardiac medications]] such as [[beta-blockers]], [[statins]], and [[antiplatelet therapy]]


==Follow-Up Care==
== Follow-Up Care ==
Post-operative follow-up care for CABG patients often involves regular check-ups with a cardiologist. This typically includes regular monitoring of cardiac function, assessment of wound healing, and adjustments to medical therapy as necessary. Education about heart-healthy lifestyle changes, such as smoking cessation, a balanced diet, regular exercise, and weight management, is also a crucial part of follow-up care.<ref>{{Cite journal|last=Smith|first=SC Jr|title=AHA/ACC Guidelines for Secondary Prevention for Patients with Coronary and other Atherosclerotic Vascular Disease: 2006 update|journal=Circulation|volume=113|issue=19|pages=2363-2372|year=2006|doi=10.1161/CIRCULATIONAHA.106.174516}}</ref>
Post-operative follow-up includes:
* Regular visits to a [[cardiologist]] for monitoring [[cardiac function]]
* Blood tests to assess [[cholesterol]] and [[glucose]] levels
* Imaging tests such as [[echocardiogram]] or [[stress test]] if symptoms recur
* Counseling for mental health, including management of anxiety or depression, which are common after heart surgery


==See also==
== See also ==
* [[Coronary artery disease]]
* [[Coronary artery disease]]
* [[Angina]]
* [[Angina]]
* [[Cardiac rehabilitation]]
* [[Cardiac rehabilitation]]
* [[Heart failure]]
* [[Heart failure]]
==References==
* [[Myocardial infarction]]
{{Reflist}}
* [[Percutaneous coronary intervention]]
 
== External Links ==
* [https://www.nhlbi.nih.gov/health-topics/coronary-artery-bypass-grafting National Heart, Lung, and Blood Institute – CABG]
* [https://www.heart.org/en/health-topics/heart-attack/treatment-of-a-heart-attack/coronary-artery-bypass-graft-surgery American Heart Association – CABG]
* [https://medlineplus.gov/ency/article/002940.htm MedlinePlus – Coronary artery bypass surgery]


==External links==
{{Cardiology}}
{{Commons category|Coronary artery bypass surgery}}
{{stub}}
{{stub}}
[[American Heart Association]]  
[[American Heart Association]]  

Revision as of 15:43, 1 April 2025

Coronary artery bypass surgery Image 657B-PH

Coronary artery bypass grafting (CABG, often pronounced "cabbage") is a common surgical procedure used to improve blood flow to the heart. It is primarily indicated for individuals with severe coronary artery disease (CAD), also known as coronary heart disease (CHD), in which a waxy substance called plaque builds up inside the coronary arteries. These arteries supply oxygen-rich blood to the heart muscle.

Procedure

CABG is performed by using a healthy blood vessel from another part of the body—commonly the saphenous vein from the leg, the radial artery from the arm, or the internal thoracic artery from the chest wall—to bypass blocked or narrowed segments of the coronary arteries. This newly grafted vessel creates an alternate route for blood to reach the heart muscle, thereby restoring adequate blood supply and oxygenation.

The surgery is typically done under general anesthesia, and the heart may be stopped temporarily using a cardiopulmonary bypass machine, or performed "off-pump" while the heart is still beating.

Indications

CABG is indicated in several clinical scenarios, including:

Risks

Like all major surgeries, CABG carries certain risks and potential complications, including:

The risks are elevated in patients with multiple comorbidities, advanced age, or poor baseline cardiac function.

Recovery and Rehabilitation

Recovery after CABG typically involves:

  • 5 to 7 days of hospitalization, including time in an intensive care or cardiac unit
  • Gradual return to daily activities over 6 to 12 weeks
  • Participation in a structured cardiac rehabilitation program, including supervised exercise, dietary counseling, and education about cardiovascular risk reduction

Wound care, medication adherence, and emotional support are important parts of the recovery process.

Outcomes

CABG is highly effective in relieving symptoms of coronary artery disease, especially angina pectoris, and can improve quality of life and longevity in appropriately selected patients. Long-term success depends on:

Follow-Up Care

Post-operative follow-up includes:

See also

External Links



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