Coronary artery bypass grafting (CABG) for Heart Disease

Overview
Coronary artery bypass grafting (also known as CABG, pronounced “cabbage”) is the most common heart surgery. CABG is considered in cases of severe coronary heart disease, where a waxy substance called plaque has built up in the coronary arteries. Plaque hardens and narrows the arteries and limits the amount of oxygen-rich blood that reaches the heart, causing angina (chest pain). Plaque can also rupture and form clots that can block the flow of blood, leading to a heart attack. Coronary bypass surgery restores the flow of blood to the heart by bypassing the blocked section of coronary artery.

What does it involve?
The goal of CABG surgery is to graft blood vessels onto the blocked coronary artery and provide an alternate route for blood to flow to the heart.

You will be under general anesthetic for CABG surgery. First, the surgeon will harvest between one and three blood vessels for grafting. These may include veins from one or both legs, an artery from your chest, and an artery from your wrist.

Next, the surgeon will open the chest. In a traditional procedure, the surgeon makes a long incision down the chest, cuts the sternum in half, and spreads the rib cage apart. The heart is then temporarily stopped while grafting surgery is performed. While the heart is stopped, blood will continue to be pumped through the body by a cardiopulmonary bypass (heart-lung) machine. When the grafts are in place, the heart is restarted, and normal blood flow is restored. The surgeon will then close the chest.

In some situations, CABG surgery can be performed using newer, minimally invasive techniques. These include keyhole surgery, which is performed using very small incisions; robotic procedures; and “off-pump” procedures during which the heart is not stopped.

Recovery
After coronary bypass surgery, you will spend one or two days in the intensive care unit (ICU) where your condition can be monitored regularly. You will continue recovery in another part of the hospital for an additional three to five days before returning home. You can expect to return to work and resume normal activities after about six weeks. Your cardiologist may recommend cardiac rehabilitation after CABG surgery.

Results
After coronary bypass surgery, most people feel better for 10 to 15 years.

Constraints
Any surgery carries risks including blood clots, blood loss, infection, breathing problems, reactions to medication, heart attack or stroke during the surgery, and death. Complications specific to heart surgery include postpericardiotomy syndrome, which can cause chest pain and low-grade fever lasting several months.

Coronary bypass surgery does not cure the underlying coronary artery disease. Over time, the coronary arteries and new grafts can become clogged again. After CABG, it is more important than ever to lower cholesterol levels and blood pressure, manage weight, and control diabetes. You will need to stop smoking, reduce your dietary fat intake, and get more exercise to prevent further complications.

For more details about this treatment, visit:
Coronary Artery Bypass Graft Surgery – Johns Hopkins Medicine
http://www.hopkinsmedicine.org/healthlibrary/te...

Coronary Artery Bypass Graft Surgery (CABG) – MedicineNet
http://www.medicinenet.com/coronary_artery_bypa...

What To Expect After Coronary Artery Bypass Grafting – National Heart, Lung, and Blood Institute
https://www.nhlbi.nih.gov/health/health-topics/...

Coronary bypass surgery - Results – Mayo Clinic
http://www.mayoclinic.org/tests-procedures/coro...