Coronary Artery Bypass Surgery (CABG)
Frequently referred to as “bypass surgery” or “open heart surgery”, Coronary Artery Bypass Graft surgery (CABG or cabbage) is the surgical treatment of choice for blocked arteries surrounding the heart.
The heart pumps blood for the entire body but still depends on a series of blood vessels called the coronary arteries for its own blood supply. If the arteries become severely blocked, a condition known as coronary artery disease, oxygen does not reach the heart muscle and damage occurs. Open heart surgery, or bypass surgery, is considered the "gold standard" treatment of coronary artery disease.
To prevent damage to the heart, flow through the coronary arteries must be increased. During a CABG the blocked arteries are removed or bypassed with blood vessels taken from another part of the body. In most surgeries, two to four coronary arteries are grafted to ensure adequate flow to the heart.
Indications for heart bypass surgery:
- Major diet changes, smoking cessation and exercise have not improved the coronary artery disease.
- Angioplasty is unsuccessful, not appropriate or the artery is becoming blocked again after angioplasty.
- Severe chest pain with activity.
- Testing shows severe disease in the left main coronary artery.
- Testing shows severe disease in multiple arteries.
- Stents did not work, could not be placed or are needed again.
- The left ventricle is not working properly due to coronary artery disease.
- There is an imminent risk of heart damage.
Preparing for heart bypass surgery:
Many cardiac surgeons order extensive testing before proceeding with a CABG to determine which arteries are obstructed and the severity of the blockage. An angiogram is one outpatient test that uses x-rays to determine the severity of coronary disease.
A stress test, electrocardiogram (EKG) and blood tests are usually done in advance of the surgery. Blood tests may be repeated immediately prior to surgery to determine if the patient is likely to bleed during surgery, along with their general health.
A surgeon may have very specific instructions for a patient scheduled for a CABG. These instructions may include changes in prescription medications, diet and drinking and smoking habits.
