Coronary artery bypass surgery

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:

• Severe multi-vessel coronary artery disease
• Significant blockage of the left main coronary artery
• 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

Risks

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

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:

• 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

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

• Coronary artery disease
• Angina
• Cardiac rehabilitation
• Heart failure
• Myocardial infarction
• Percutaneous coronary intervention

External Links

• National Heart, Lung, and Blood Institute – CABG
• American Heart Association – CABG
• MedlinePlus – Coronary artery bypass surgery

Cardiovascular disease A-Z

Most common cardiac diseases

• Cardiac arrhythmia‎
• Cardiogenetic disorders‎
• Cardiomegaly‎
• Cardiomyopathy‎
• Cardiopulmonary resuscitation‎
• Chronic rheumatic heart diseases‎
• Congenital heart defects‎
• Heart neoplasia‎
• Ischemic heart diseases‎
• Pericardial disorders
• Syndromes affecting the heart‎
• Valvular heart disease‎

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

A

• Accelerated idioventricular rhythm
• Acute decompensated heart failure
• Arteriosclerotic heart disease
• Athletic heart syndrome
• Atrial flutter
• Atrioventricular fistula
• Cardiovascular disease in Australia
• Autoimmune heart disease

B

• Brown atrophy of the heart

C

• Ebb Cade
• Cardiac allograft vasculopathy
• Cardiac amyloidosis
• Cardiac asthma
• Cardiac tamponade
• Cardiogenic shock
• Cardiogeriatrics
• Cardiorenal syndrome
• Cardiotoxicity
• Carditis
• Coronary artery aneurysm
• Coronary artery anomaly
• Coronary artery disease
• Spontaneous coronary artery dissection
• Coronary artery ectasia
• Coronary occlusion
• Coronary steal
• Coronary thrombosis
• Coronary vasospasm
• Cœur en sabot
• Coxsackievirus-induced cardiomyopathy

D

• Duke Treadmill Score
• Duroziez's disease

E

• Eisenmenger's syndrome
• Embryocardia
• Endocardial fibroelastosis
• Eosinophilic myocarditis

H

• Heart attack
• Heart failure
• Heart failure with preserved ejection fraction
• Heart to Heart (1949 film)
• High-output heart failure
• Hyperdynamic precordium

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

I

• Idiopathic giant-cell myocarditis
• Interventricular dyssynchrony
• Intraventricular dyssynchrony
• Isolated atrial amyloidosis

K

• Keshan disease

L

• Loeffler endocarditis

M

• Mydicar
• Myocardial bridge
• Myocardial disarray
• Myocardial rupture
• Myocardial scarring
• Myocardial stunning
• Myocarditis

N

• Nonbacterial thrombotic endocarditis

O

• OLR1
• Ostial disease

P

• Papillary fibroelastoma
• Pathophysiology of heart failure
• Postpericardiotomy syndrome
• Pulmonary vein stenosis

R

• Right axis deviation
• Roemheld syndrome

S

• Saturated fat and cardiovascular disease
• SCAR-Fc
• Shone's syndrome
• Strain pattern
• Subacute bacterial endocarditis
• Sudden cardiac death of athletes

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

T

• Traumatic cardiac arrest

V

• Ventricular aneurysm
• Vibroacoustic disease
• Viral cardiomyopathy

W

• Waon therapy

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