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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.
Coronary Artery Bypass Surgery
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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
. 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:
Severe blockage in the main artery or in several blood vessels that supply blood to the heart
that does not improve with other treatments
Your doctor will likely do the following: Physical examChest x-rayElectrocardiogram (ECG, EKG)Coronary angiogram
Talk to your doctor about your medication. You may need to stop taking certain medication for one week before surgery, such as: Aspirin and other nonsteroidal anti-inflammatory drugs (eg, ibuprofen , naproxen )Blood-thinning drugs, such as warfarin (Coumadin)Anti-platelet drugs, such as clopidogrel (Plavix)
Your doctor may also ask you to: Eat a light meal the night before. Do not eat or drink anything after midnight.Arrange for a ride to and from the hospital.Arrange for help at home after 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: Heart monitorPacing wires to control heart rateTubes connected to a machine to drain fluids from the woundBreathing tube or an oxygen maskCatheter inserted into the bladder
Anesthesia prevents pain during surgery. You may be given medication for any pain during recovery.
To reduce the risk of fluid buildup in your lungs,
breathe deeply and cough
10-20 times every hour.If a leg vein was removed, elevate your legs above your heart while sitting. Do not cross your legs.Efforts will be made to get you out of bed and walking as soon as possible.Dressings will be removed in a day or two. Pacing wires and chest tubes will be removed after a few days.
When you return home, do the following to help ensure a smooth recovery: Ask your doctor about when it is safe to shower, bathe, or soak in water.
Take medicines as directed by your doctor, such as:
AntiarrhythmicsBlood thinnersCholesterol-lowering medicineBlood pressure medicinePain medicineFollow your doctor's guidelines for caring for your stitches and staples. For example, internal stitches will dissolve. Staples will be taken out 5-7 days after surgery. Small paper strips on the incisions will peel off. They can be removed one week after discharge.Weigh yourself every morning.Follow the cardiac rehabilitation program that was created for you.If recommended by your doctor, work with a registered dietician.Make lifestyle changes, like exercising regularly, not smoking, and eating a healthy diet.Ask your doctor when you can drive and return to work.
Be sure to follow all of your doctor's
Bypass surgery does not cure heart disease. The grafted blood vessels can also become clogged. You will be encouraged to make healthy lifestyle changes.
Pain that you cannot control with the medication you have been givenSigns of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or discharge at the incision sitesNausea and/or vomiting that you cannot control with the medication you were given after surgery or that lasts longer than expectedCough, shortness of breath, or chest painPain, burning, urgency, frequency of urination, or persistent blood in the urineGaining more than four pounds within one or two daysPain and/or swelling in your feet, calves, or legs, or sudden shortness of breath or chest pain
In case of an emergency, call for medical help right away.
12/3/2010 DynaMed's Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance
: Morone NE, Weiner DK, Belnap BH, et al. The impact of pain and depression on recovery after coronary artery bypass grafting.
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.
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