Coronary artery bypass graft (CABG)

One option to treat the blocked coronary artery is a surgical procedure called coronary artery bypass grafting surgery. The procedure involves taking a section of blood vessel from elsewhere in the body, such as the leg, and grafting it onto a location on the heart, which allows blood to bypass the blocked portion of the coronary artery.

The procedure begins with the surgeon making a cut in the leg and removing a section of vein. Both ends of the vein are tied-off in the leg and cut is closed. The chest is opened and the blood is rerouted through a heart-lung machine. The heart is then stopped.

The surgeon will then divide the sternum, the bone that runs down the middle of the chest, exposing the chest cavity. The heart is then usually connected to a heart-lung machine, which takes over the work of the heart and lungs during the treatment. Once this is competed, the heart is stopped. The surgeon then locates the blocked coronary artery and attaches the section of vein taken from the leg to the aorta and to the coronary artery below the blocked segment of the artery. The surgeon may do as many bypasses on as many blocked coronary arteries as the patient needs.

Once each bypass graft is placed, it is checked for leaks. Following this, the heart is restarted. Once the heart is beating again, the surgeon will remove its attachments to the heart-lung machine and sew the openings closed. Following this the chest is closed. A pacemaker may be inserted during the procedure to help control any heart rhythm problems the patient may have.

Revision

Last reviewed 11/8/2010 by Glenn Gandelman, MD, MPH, FACC Assistant Clinical Professor of Medicine at New York Medical College, and in private practice specializing in cardiovascular disease in Greenwich, CT. Review provided by VeriMed Healthcare Network. Previously reviewed by Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington (6/21/2010).

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