Learn how we develop our content. To learn more about Healthwise, visit Healthwise. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Updated visitor guidelines. Top of the page. Topic Overview During coronary artery bypass graft CABG surgery, your surgeon will use a healthy blood vessel from another part of your body to create an alternate route, or bypass, around narrowed or blocked sections of your coronary arteries.
Opening the chest Your surgeon will make a cut, or incision, in the middle or side of your chest. Harvesting a vein to use as a graft blood vessel The surgeon can remove a piece of healthy blood vessel from these places in the body: The inside of your leg Your forearm Just behind your chest wall These blood vessels will be used as bypass grafts around narrowed or blocked portions of your coronary arteries.
Using a chest-wall artery for a graft vessel Besides your saphenous vein and radial arteries, other blood vessels can be used as bypass grafts. These arteries have two distinct advantages besides their location: Mammary arteries are already attached to the main artery the aorta. This means that only its other end must be disconnected and grafted onto the diseased coronary artery. Veins carry blood from the body back to the heart and aren't under as much pressure.
Putting you on the heart-lung bypass machine After your coronary arteries have been exposed and a usable blood vessel segment has been harvested, your surgical team may place you on a heart-lung bypass machine.
Bypassing your diseased coronary arteries Your surgeon will start to operate on the coronary arteries. Preventing blood loss during surgery During the surgery, blood may spill into your chest cavity as small blood vessels are cut.
Restarting your heart If you are on the heart-lung bypass machine, your doctor will restart your heart. Closing your chest cavity Prior to closing up your sternum, your surgeon will place several small tubes inside your chest cavity, with one end exiting your body through an incision in your upper abdomen. Final thoughts Although the CABG procedure is considered a relatively safe procedure, it also involves certain risks.
Circulation, 23 : e—e Sabik JF, et al. Coronary bypass surgery. In V Fuster et al. New York: McGraw-Hill. Credits Current as of: August 31, Top of the page Next Section: Related Information. Your risk of having a heart attack , heart failure, or another cardiac issue depends on the number of arteries blocked.
Blockage in more arteries also means that the surgery may take longer or become more complex. When a material in your blood called plaque builds up on your arterial walls, less blood flows to the heart muscle. This type of coronary artery disease CAD is known as atherosclerosis.
Atherosclerosis can affect any arteries in the body. Your doctor may recommend heart bypass surgery if your coronary arteries become so narrowed or blocked that you run a high risk of a heart attack. Your doctor will also recommend bypass surgery when the blockage is too severe to manage with medication or other treatments. A team of doctors, including a cardiologist, identify whether you can undergo open-heart surgery.
Some medical conditions can complicate surgery or eliminate it as a possibility. Discuss these issues with your doctor before scheduling your surgery. Planned surgery outcomes are usually better than emergency surgery. As with any open-heart surgery, heart bypass surgery carries risks. Recent technological advancements have improved the procedure, increasing the chances of a successful surgery. In the past decade, more alternatives to heart bypass surgery have become available.
These include:. During this treatment, a tube is threaded through your blocked artery. Afterward, a small balloon is inflated to widen the artery. The doctor then removes the tube and the balloon. A small metal scaffold, also known as a stent , will be left in place. A stent keeps the artery from contracting back to its original size. Enhanced external counterpulsation EECP is an outpatient procedure.
It can be performed as an alternative to heart bypass surgery, according to multiple studies. EECP involves compressing blood vessels in the lower limbs. This increases blood flow to the heart. The extra blood is delivered to the heart with every heartbeat. There are some medications you can consider before resorting to methods such as heart bypass surgery. Beta-blockers can relieve stable angina. You can use cholesterol-reducing drugs to slow plaque buildup in your arteries.
Your doctor may also recommend a daily dose of low-dose aspirin baby aspirin to help prevent heart attacks. Aspirin therapy is very effective in people with a prior history of atherosclerotic cardiovascular disease such as heart attack or stroke.
Eating a diet high in omega-3 fatty acids and low in saturated and trans fats helps your heart stay healthy. These may include:. Your rib cage is then spread apart to expose your heart.
Your surgeon may also opt for minimally invasive surgery, which involves smaller cuts and special miniaturized instruments and robotic procedures. You may be hooked up to a cardiopulmonary bypass machine that circulates oxygenated blood through your body while your surgeon operates on your heart. Your surgeon then removes a healthy blood vessel from the leg to bypass the blocked or damaged portion of your artery.
Make arrangements for assistance after your surgery. It will take about four to six weeks for you to recover to the point where you can resume driving, return to work and perform daily chores.
If your coronary bypass surgery isn't performed as emergency surgery, you'll likely be admitted to the hospital the morning of the surgery. Coronary bypass surgery generally takes between three and six hours and requires general anesthesia. The number of bypasses you need depends on where in your heart and how severe your blockages are.
For general anesthesia, a breathing tube is inserted through your mouth. This tube attaches to a ventilator, which breathes for you during and immediately after the surgery. Most coronary bypass surgeries are done through a long incision in the chest while a heart-lung machine keeps blood and oxygen flowing through your body. This is called on-pump coronary bypass surgery. The surgeon cuts down the center of the chest along the breastbone and spreads open the rib cage to expose the heart.
After the chest is opened, the heart is temporarily stopped with medication and a heart-lung machine takes over to circulate blood to the body.
The surgeon takes a section of healthy blood vessel, often from inside the chest wall or from the lower leg, and attaches the ends above and below the blocked artery so that blood flow is redirected around the narrowed part of the diseased artery.
After completing the graft, the surgeon will restore your heartbeat, disconnect you from the heart-lung machine and use wire to close your chest bone.
The wire will remain in your body after the bone heals. Expect to spend a day or two in the intensive care unit. The breathing tube will remain in your throat until you are awake and able to breathe on your own. Cardiac rehabilitation often begins while you're still in the hospital.
You'll be given an exercise and education program designed to help you recover. You'll continue with monitored programs in an outpatient setting until you can safely follow a home-based maintenance program. Barring complications, you'll likely be discharged from the hospital within a week.
You still might have difficulty doing everyday tasks or walking a short distance. If, after returning home, you have any of the following signs or symptoms, call your doctor:. Expect a recovery period of about six to 12 weeks. If you have your doctor's OK, you can return to work, begin exercising and resume sexual activity after four to six weeks. After surgery, most people feel better and might remain symptom-free for as long as 10 to 15 years.
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