Coronary Artery Bypass Surgery (CABG)

Why might it be required?

CABG is performed as open heart surgery when the heart has been found to have an inadequate blood supply during a coronary angiogram. The narrowings in the coronary arteries in this instance might not be appropriate for balloon angioplasty and/or a stent. CABG is performed to bypass the narrowings in the coronary arteries to ensure that the heart is receiving a good blood supply beyond the blockages.  

What happens during the operation?

A general anaesthetic is required during the procedure. New blood vessels (grafts) are selected from either the veins in the legs or arteries from the arms or chest wall.  These vessels are surplass to the body's requirements so they can usually be removed safely. Access to the heart is gained through the chest wall via a sternotomy incision (pictured). Sometimes the surgeon will perform the operation when the heart is still beating 'off-pump'. In practice it is more common for the operation to be done 'on-pump', when the heart is cooled and stopped, with a heart-lung machine taking over.  This ensures that the blood is oxygenated and circulates around the body. The bypass grafts are then attached to the aorta and to the original coronary artery beyond the blockage. Once all the narrowings have been grafted the heart is restarted and the heart and lung bypass machine is discontinued. The chest wall incision is then closed and the patient istaken to recovery to wake up.  

What happens after the operation?

The first 24 hours after surgery are normally spent in an Intensive Care unit. Patients are normally discharged after 5-7 days.  Following this each individual patient's recovery vwill vary considerably however most people take several months return to their baseline.