Coronary Artery Bypass Grafting (CABG)
Experts in Heart Attack Prevention and Treatment
Coronary artery bypass grafting (CABG) is the most common heart surgery for treating coronary artery disease. You may need this surgery if the arteries that supply blood and oxygen to your heart become too narrow or clogged.
Treatment Overview
During coronary artery bypass grafting (CABG), our cardiothoracic surgeons remove a blood vessel from your leg, arm or chest wall to reroute blood around the blocked artery and restore blood flow to the heart. Some patients only need a single bypass, but if more than one artery is affected, we may do a double, triple or quadruple bypass.
We perform bypass surgery while you’re under general anesthesia, which means you’ll be asleep. In some cases, we connect you to a heart-lung bypass machine that does the work of your heart and lungs during your surgery. However, most of the time, we try to operate while your heart is still beating, which is known as off-pump surgery. It’s a less-invasive approach that lowers complication risks and leads to quicker recovery.
What to Expect
With any heart procedure, it helps to know what you can expect in advance. We’re here to guide you before, during and after your procedure – answering any questions, helping you prepare for surgery and recovery, explaining potential risks and offering whatever support you need along the way.
Frequently Asked Questions
You may be a candidate for CABG if the coronary arteries that supply blood to your heart are severely narrowed or blocked, and other treatments, like an angioplasty, haven’t worked.
If you’ve had a severe heart attack, emergency CABG may be necessary. CABG can also be preventive to decrease your risk of heart attack.
Your heart doctor will review your medical history in detail and perform several tests to make sure that you’re a good candidate for CABG.
On the morning of your surgery, you’ll come to the hospital for heart tests and blood tests, so we can confirm it’s safe to do the procedure. You’ll also receive an IV sedative to help you relax.
Then, you’ll head to the operating room, where you’ll get an IV with general anesthesia to put you to sleep during the surgery. You’ll also have a breathing tube in your mouth that’s attached to a ventilator, which helps you breathe during and shortly after surgery.
You’ll be in surgery for 3 to 6 hours, depending on the specific procedure. After surgery, you’ll go to the ICU for close monitoring.
Open-heart surgeries typically require blood transfusion, but with minimally invasive surgery, most patients don’t need a transfusion because there’s less blood loss. Whenever possible, we perform bloodless surgery, designed to prevent the loss of blood and eliminate the need for blood transfusions.
Your heart stops during CABG if your surgeon uses an on-pump approach, which means a machine takes over your heart and lungs during surgery.
More commonly, our surgeons perform a less-invasive, off-pump surgery, operating while your heart is still beating. This often results in shorter surgery times and faster recovery.
Recovery from CABG is different for everyone but usually takes about 6 to 12 weeks. Most patients spend at least a week in the hospital after surgery before they recover at home.
Your doctor will let you know when it’s safe to return to normal activities, such as driving, lifting heavy objects or exercising.
As you recover from heart surgery, call your doctor if you have any concerns. Contact your care team right away, if any of the following occur
- Chills
- Continuous nausea or vomiting
- Fast or irregular heart rate
- Fever that’s 100.4ºF or higher
- Numbness in the arms and legs
- Pain, redness, swelling or bleeding from your incision
- Swelling, especially in the legs
Call 911 if you have trouble breathing or think you’re having a heart attack or stroke.
Lifestyle changes before and after surgery are important for improving heart health. Our cardiac rehab programs can help you modify your habits for better long-term recovery. Some examples include:
- Eating a heart-healthy diet full of fruits, vegetables and whole grains
- Exercising regularly
- Finding ways to manage stress
- Getting quality sleep
- Quitting smoking
It depends. Some people do well for over 20 years after a coronary bypass. Others need another bypass within 10 years after surgery because they have a new blockage.
There are some ways to prevent blockages, such as working to lower your low-density lipoprotein (LDL) cholesterol and quitting smoking.