Coronary Artery Bypass Grafting (CABG) is a type of surgery that improves blood flow to the heart. It's typically used to treat severe coronary heart disease (CHD), which occurs when the coronary arteries become narrowed or blocked due to atherosclerosis or other causes. CABG can relieve chest pain, improve the patient's ability to be active, and potentially reduce the risk of a heart attack.

How CABG Is Performed

  1. Graft Selection: A healthy artery or vein from the body is used as a graft to bypass the blocked artery. The graft could be a vein from the leg (saphenous vein), an artery from the chest (internal mammary artery), or an artery from the arm (radial artery).

  2. Surgical Procedure:
    • Traditional CABG: The most common form, where the chest is cut open to access the heart. The patient is placed on a heart-lung bypass machine, which takes over the heart's pumping action during the surgery.

    • Off-Pump CABG: Performed on the still-beating heart without the use of a heart-lung machine.

    • Minimally Invasive CABG: Involves smaller incisions and may or may not use a heart-lung machine.

Indications for CABG

  • Multiple Blocked Coronary Arteries: Especially if the heart's pumping action has already been weakened.

  • Severe Blockages: That cannot be treated with angioplasty or stenting.

  • Previous Stent Placement: If the stent has failed.

  • Emergency Situations: Such as a severe heart attack.

Risks and Considerations

  • Risks: Include bleeding, infection, kidney problems, stroke, heart attack, or death. The risks are higher in people with other health problems, like diabetes or kidney disease.

  • Recovery: Recovery time can vary but generally includes a hospital stay followed by several weeks of recovery at home. Full recovery may take several months.

Benefits of CABG

  • Symptom Relief: Particularly effective for reducing chest pain (angina).

  • Improved Heart Function: Especially if the heart's pumping ability has been reduced.

  • Increased Survival: Especially beneficial for high-risk patients and those with multiple or severe blockages.

Postoperative Care

After CABG, patients are typically advised to make lifestyle changes to improve heart health, such as quitting smoking, eating a heart-healthy diet, exercising, and managing stress. Regular follow-up appointments and possibly medications are also part of post-surgery care.

CABG is a major surgery and requires thorough discussions between the patient and their healthcare team to understand the risks, benefits, and long-term implications of the procedure.