What Is Coronary Artery Bypass Grafting?

Coronary artery bypass grafting (CABG) is a type of surgery called revascularization (re-VAS-kyu-lar-i-ZA-shun), used to improve blood flow to the heart in people with severe coronary artery disease (CAD).

CAD occurs when the arteries that supply blood to the heart muscle (the coronary arteries) become blocked due to the buildup of a material called plaque (plak) on the inside of the blood vessels. If the blockage is severe, chest pain (also called angina), shortness of breath, and, in some cases, heart attack can occur.

CABG is one treatment for CAD. During CABG, a healthy artery or vein from another part of the body is connected, or grafted, to the blocked coronary artery. The grafted artery or vein bypasses (that is, it goes around) the blocked portion of the coronary artery. This new passage routes oxygen-rich blood around the blockage to the heart muscle. As many as four major blocked coronary arteries can be bypassed during one surgery.

Overview

CABG is the most common type of open-heart surgery in the United States, with more than 500,000 surgeries performed each year. Doctors called cardiothoracic (KAR-de-o-tho-RAS-ik) surgeons perform this surgery.

CABG isn’t used for everyone with CAD. Many people with CAD can be treated by other means, such as lifestyle changes, medicines, and another revascularization procedure called angioplasty.

CABG may be an option if you have severe blockages in the large coronary arteries that supply a major part of the heart muscle with blood—especially if the heart’s pumping action has already been weakened.

CABG may also be an option if you have blockages in the heart that can’t be treated with angioplasty. In these situations, CABG is considered more effective than other types of treatment.

If you’re a candidate for CABG, the goals of having the surgery are to:

• Improve your quality of life and decrease angina and other symptoms of CAD
• Resume a more active lifestyle
• Improve the pumping action of the heart if it has been damaged by a heart attack
• Lower the chances of a heart attack (in some patients, such as those with diabetes)
• Improve your chance of survival

Repeat surgery may be needed if grafted arteries or veins become blocked, or if new blockages develop in arteries that weren’t blocked before. Taking medicines as prescribed and making lifestyle changes that your doctor recommends can lower the chance of a graft becoming blocked.

In people who are candidates for the surgery, the results are usually excellent, with 85 percent of people having significantly reduced symptoms, less risk for future heart attacks, and a decreased chance of dying within 10 years following the surgery.

March 2007