What is coronary artery bypass grafting (CABG) surgery?

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Dr. George C. Clinard, MD
Cardiologist (Heart Specialist)

Coronary artery bypass is a procedure used to reroute the blood supply around a blocked section of a coronary artery. Surgeons remove healthy blood vessels from another part of the body, such as the leg or chest wall. Then the surgeons surgically attach the vessels to the diseased artery in such a way that the blood can flow around the blocked section.

Coronary artery bypass grafting (CABG) surgery (often pronounced “cabbage”) is used to treat blockages in coronary arteries. CABG is designed to bypass the blockages in the coronary arteries in order to restore normal or near normal blood flow to the entire heart during rest and exercise. CABG is the most commonly performed heart operation in the United States. Though an occasional patient needs only one bypass graft, most people who are candidates for CABG have blockages in most of their coronary arteries and need between three and five bypass grafts.

The surgeon will take a healthy blood vessel (artery or vein from the body), usually from the leg, arm, chest or abdomen and connect it to the other arteries (usually the aorta) in the heart. This enables blood flow to “bypass,” or go around, the diseased or blocked portion of the coronary artery, creating a new path for blood flow to the heart.

Coronary bypass surgery typically takes between three and five hours to perform. To begin the CABG operation, a cardiac surgeon will make an incision down the front of the chest, usually dividing the breastbone or sternum. This incision is called a median sternotomy, and it enables the surgeon to safely operate on all parts of the heart. The size of the actual incision varies from surgeon to surgeon.

This content originally appeared online in "The Patient Guide to Heart, Lung, and Esophageal Surgery" from the Society of Thoracic Surgery.

During a coronary artery bypass graft, also called a bypass or CABG, a blood vessel taken from the leg, wrist or chest is attached to the coronary artery to bypass a blockage and restore blood flow to the heart.

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

A coronary artery bypass graft, or CABG for short, is a surgical procedure to treat coronary artery disease. Watch this animation to learn more about the procedure.

Also known as coronary artery bypass surgery (or CABG—pronounced like the vegetable cabbage), bypass surgery is one way to treat heart artery blockages. It is a major operation performed in a hospital operating room. The surgeon uses a patient’s own arteries or veins to create a detour so blood can flow around a blockage in a heart artery, much like a detour around a washed-out bridge.

Coronary artery bypass grafting (CABG) is a type of surgery called revascularization, used to improve blood flow to the heart in people with severe CAD. CAD occurs when the arteries that supply blood to the heart muscle become blocked due to the buildup of a material called plaque on the inside of the blood vessels. If the blockage is severe, chest pain, shortness of breath, and, in some cases, heart attack can occur.

CABG is one treatment for CAD. During CABG, a healthy artery or vein from another part of the body is connected, or grafted, to the blocked coronary artery. The grafted artery or vein bypasses the blocked portion of the coronary artery. This new passage routes oxygen-rich blood around the blockage to the heart muscle. As many as four major blocked coronary arteries can be bypassed during one surgery.

Overview
CABG is the most common type of open-heart surgery in the United States. CABG isn't used for everyone with CAD. Many people with CAD can be treated by other means, such as lifestyle changes, medicines, and another revascularization procedure called angioplasty. CABG may be an option if you have blockages in the heart that can't be treated with angioplasty.

If you're a candidate for CABG, the goals of having the surgery are to:

  • Improve your quality of life and decrease angina and other symptoms of CAD
  • Resume a more active lifestyle
  • Improve the pumping action of the heart if it has been damaged by a heart attack
  • Lower the chances of a heart attack
  • Improve your chance of survival
  • Repeat surgery may be needed if grafted arteries or veins become blocked, or if new blockages develop in arteries that weren't blocked before. Taking medicines as prescribed and making lifestyle changes that your doctor recommends can lower the chance of a graft becoming blocked.

In people who are candidates for the surgery, the results are usually excellent, with 85 percent of people having significantly reduced symptoms, less risk for future heart attacks, and a decreased chance of dying within 10 years following the surgery.

This answer from the National Heart, Lung and Blood Institute has been reviewed and/or edited by Dr. William D. Knopf.

Coronary artery bypass grafts (CABG) deliver a new source of blood to regions of the heart served by blocked arteries. Surgeons use segments of the patient's own veins and arteries to go around, or bypass, these blockages. If left untreated, severely blocked arteries may lead to heart attack or death. Coronary bypass operations are performed half a million times a year with an overall success rate of almost 98 percent.

Coronary artery bypass grafting (CABG) is an open heart surgery in which a blood vessel is used to create a bypass route around a blocked coronary artery. The goal is to restore blood supply to an area of the heart. A bypass graft can be a portion of a vessel taken from the leg or arm or a repositioned artery from the chest wall.

Coronary artery bypass grafting (CABG) surgery, which is the most commonly performed heart operation in the United States, is designed to bypass the blockages in the coronary arteries in order to create a new path for blood flow to the heart. With CABG, the surgeon removes a healthy blood vessel, usually from the leg, arm, chest or abdomen, and connects it to other arteries (usually the aorta) in the heart. This enables blood flow to “bypass,” or go around, the diseased or blocked portion of the coronary artery.

Dr. Brian D. Mott, MD
Cardiothoracic Surgeon

Basically this is surgical plumbing. Imagine you have a sink on the 2nd floor of your house that is not draining because a pipe somewhere between the 2nd floor and the basement is blocked and clogged up. You don't want to tear up the floors and walls to fix the clogged pipe so you attach a new pipe to drain the sink upstairs and reattach it in the basement where the pipe exits to the sewer. You in fact "bypass" the blocked pipe and reroute the water downstream. Sounds easy right? It's slightly more complicated to do this on a human heart but the concept is essentially the same.

Surgeons bypass the blocked coronary arteries with vein or arterial grafts which are hollow tubes like pipes by sewing them to coronary arteries downstream beyond the blockages and get the inflow of blood by attaching them to the aorta upstream. This brings a better flow of blood into the territory of heart muscle that is not being perfused by the blocked coronary arteries. Problem fixed.

Dr. George C. Clinard, MD
Cardiologist (Heart Specialist)

Coronary artery bypass grafting (CABG) is the most common surgical treatment for acquired heart disease.

During traditional coronary artery bypass surgery (CABG), the surgeon makes an incision down the center of the chest and through the breastbone to gain access to the heart. The heart is temporarily stopped and the patient's blood is shunted into a heart-lung machine, which substitutes for the beating heart and lungs during surgery. Blood vessels from the chest cavity, arm, or legs are used as replacements for the diseased coronary vessel. These donor vessels can be removed safely because other blood vessels can adequately supply the part of the body from which they were taken.

Following completion of the grafting procedure, the heart is stimulated electrically to re-establish its beat, the patient is taken off the heart-lung machine, and the incision in the chest is closed.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.