What Are the Risks of Coronary Artery Bypass Grafting?

Although complications from coronary artery bypass grafting (CABG) are uncommon, the risks include:

• Wound infection and bleeding
• Anesthesia reactions
• Fever
• Pain
• Stroke, heart attack, or even death

Some patients can develop a fever associated with chest pain, irritability, and decreased appetite. This is due to inflammation involving the lung and heart sac, and is sometimes seen 1 to 6 weeks after surgeries that involve cutting through the pericardium (the outer covering of the heart). This reaction is usually a mild, self-limited illness, but some patients may develop fluid buildup around the heart that requires treatment.

Use of the heart-lung machine also can cause complications. Memory loss and other changes, such as difficulty concentrating or thinking clearly, may occur in some people. These changes are more likely to occur in people who are older, who have high blood pressure or lung disease, or who drink excessive amounts of alcohol. These side effects often improve several months after surgery.

The heart-lung machine also increases the risk of blood clots forming in your blood vessels. Clots can travel to the brain or other parts of the body and block the flow of blood, which can cause stroke or other problems. Recent technical improvements in heart-lung machines are helping to reduce the risk of blood clots forming.

In general, the chances of developing complications are higher when CABG is done in an emergency situation (for example, if performed during a heart attack), if you're over age 70, or if you have a history of smoking. Your risks also are higher if you have other diseases or conditions such as diabetes, kidney disease, lung disease, or peripheral vascular disease.