A coronary artery bypass graft (CABG) is a heart surgery that is used to bypass damaged sections of the coronary artery in the heart by grafting them with a healthy blood vessel taken from another area of the body. The CABG procedure is an open heart procedure, so the patient is first placed under anesthesia. Next, an artery or vein from another part of the body is removed to be used in the grafting procedure. During the surgery, this new blood vessel is attached to the damaged areas of the coronary artery, and blood flow is redirected through it to improve cardiac output.
The replacement vein or artery used in a CABG procedure can come from any of several places in the body. Veins can be taken from the lower leg, attached to the aorta in the heart and subsequently grafted beyond the damaged area of the coronary artery. An vessel such as the mammary artery can be taken from the chest region and grafted beyond the blocked coronary artery in the heart. Finally, a portion of the forearm's radial artery might be taken. The location and vessel chosen depends on the size of the diseased area in the heart, the extent of the blockage and the patient's overall health.
As the open heart section of the CABG procedure begins, the surgeon makes an incision of about 6-8 inches (15.2-20.3 cm) in the front portion of the patient's chest. The heart is stopped and is placed on a heart-lung bypass machine. This machine artificially performs the work of the heart by pumping blood and oxygen around the body. It allows the surgeon to work with delicate heart tissues and vessels without the complication of the movement associated with a beating heart.
When it is time to graft the vessel removed from another area of the body, the surgeon makes another incision just below the blocked section of coronary artery. The graft is stitched into the opening that has been created so that blood will flow around the blockage. If there is more than one blocked or damaged artery, this procedure is repeated until all vessels are clear.
The CABG procedure typically lasts about three to five hours. The patient's heart is shocked to make it start beating again, and the heart-lung machine is turned off. After the patient's chest has been closed with wire and sewn up using internal and external stitches, the patient is taken to a recovery room. He or she is monitored for at least two days in intensive care.