What Is Coronary Artery Bypass Grafting?
Coronary artery bypass grafting (CABG) is a type of surgery that improves blood flow to the heart. Surgeons use
CABG to treat people who have severe coronary heart disease (CHD).
CHD is a disease in which a waxy substance called plaque builds up inside the coronary arteries. These arteries
supply oxygen-rich blood to your heart.
Over time, plaque can harden or rupture (break open). Hardened plaque narrows the coronary arteries and reduces
the flow of oxygen-rich blood to the heart. This can cause chest pain or discomfort called angina.
If the plaque ruptures, a blood clot can form on its surface. A large blood clot can mostly or completely block blood
flow through a coronary artery. This is the most common cause of a heart attack. Over time, ruptured plaque also
hardens and narrows the coronary arteries.
CABG is one treatment for CHD. During CABG, a healthy artery or vein from the body is connected, or grafted, to the
blocked coronary artery. The grafted artery or vein bypasses (that is, goes around) the blocked portion of the
coronary artery. This creates a new path for oxygen-rich blood to flow to the heart muscle.
Surgeons can bypass multiple coronary arteries during one surgery.
Coronary Artery Bypass Grafting
Figure A shows the location of the heart. Figure B shows
how vein and artery bypass grafts are attached to the heart.
Overview
CABG is the most common type of open-heart surgery in the United States. Doctors called cardiothoracic surgeons
do this surgery.
However, CABG isn't the only treatment for CHD. Other treatment options include lifestyle changes, medicines, and a
procedure called coronary angioplasty.
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Angioplasty is a nonsurgical procedure that opens blocked or narrow coronary arteries. During angioplasty, a stent
might be placed in a coronary artery to help keep it open. A stent is a small mesh tube that supports the inner artery
wall.
CABG or angioplasty may be options if you have severe blockages in your large coronary arteries, especially if your
heart's pumping action has already grown weak.
CABG also may be an option if you have blockages in the heart that can't be treated with angioplasty. In this
situation, CABG may work better than other types of treatment.
The goals of CABG may include:

Improving your quality of life and reducing angina and other CHD symptoms

Allowing you to resume a more active lifestyle

Improving the pumping action of your heart if it has been damaged by a heart attack

Lowering the risk of a heart attack (in some patients, such as those who have diabetes)

Improving your chance of survival
Outlook
The results of CABG usually are excellent. The surgery improves or completely relieves angina symptoms in most
patients. Although symptoms can recur, many people remain symptom-free for as long as 10 to 15 years. CABG also
may lower your risk of having a heart attack and help you live longer.
You may need repeat surgery if blockages form in the grafted arteries or veins or in arteries that weren't blocked
before. Taking medicines and making lifestyle changes as your doctor recommends can lower the risk of a graft
becoming blocked.
Types Of Coronary Artery Bypass Grafting
There are several types of coronary artery bypass grafting (CABG). Your doctor will recommend the best option for
you based on your needs.
Traditional Coronary Artery Bypass Grafting
Traditional CABG is used when at least one major artery needs to be bypassed. During the surgery, the chest bone is
opened to access the heart.
Medicines are given to stop the heart; a heart-lung bypass machine keeps blood and oxygen moving throughout the
body during surgery. This allows the surgeon to operate on a still heart.
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After surgery, blood flow to the heart is restored. Usually, the heart starts beating again on its own. Sometimes mild
electric shocks are used to restart the heart.
Off-Pump Coronary Artery Bypass Grafting
This type of CABG is similar to traditional CABG because the chest bone is opened to access the heart. However, the
heart isn't stopped, and a heart-lung bypass machine isn't used. Off-pump CABG sometimes is called beating heart
bypass grafting.
Minimally Invasive Direct Coronary Artery Bypass Grafting
This type of surgery differs from traditional CABG because the chest bone isn't opened to reach the heart. Instead,
several small cuts are made on the left side of the chest between the ribs. This type of surgery mainly is used to
bypass blood vessels at the front of the heart.
Minimally invasive bypass grafting is a fairly new procedure. It isn't right for everyone, especially if more than one or
two coronary arteries need to be bypassed.
Other Names For Coronary Artery Bypass Grafting

Bypass surgery

Coronary artery bypass surgery

Heart bypass surgery
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