A Patient's Guide to Heart Surgery
Conventional Heart Bypass Surgery
Coronary Artery Bypass Graft (CABG)
Coronary Artery Bypass Grafting (CABG), or bypass surgery, is a surgical operation in which the surgeon uses a section of vein, usually from the patient's leg, or an artery from inside the patient's chest, to create a new route for oxygen-rich blood to reach the heart muscle.
The most commonly used vessels are the internal mammary arteries, which are inside the chest wall, or the greater saphenous veins, which are in the leg. These vessels are "spares." Blood flow is usually not affected by removing them. Less often, the radial artery in the arm may be used for a graft. Grafts usually last for 10 to 12 years.
One end of the vein or artery is connected to the coronary artery that is blocked or narrowed beyond the blockage or narrowed area. The other end of the vein is connected to the aorta. Usually the other end of the artery is left connected to the main artery from which it branches. By creating this new conduit for blood flow to the heart muscle, the graft is said to "bypass" the narrowed or blocked section of the coronary artery in question. Depending on the number and location of blockages, between one and seven bypasses are performed.
A heart-lung machine is used to circulate and oxygenate the blood while the surgeon works on the stopped heart. The heart is accessed by dividing the patient's sternum with a 10-12" long incision on the patient's chest. After the bypasses are complete, the heart is restarted until it is beating normally, and the patient is removed from the heart-lung machine. A wire sternotomy suture is used to close up the sternum, and sutures or clips are used to close up the chest and leg wounds.
A patient who undergoes CABG surgery usually stays in the ICU for approximately 2 days, with a total hospital stay of 7-10 days.