Coronary artery bypass graft surgery typically takes between three and six hours. The length of the surgery depends on factors like how many bypass grafts are needed and the overall complexity of the procedure.
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What is coronary artery bypass grafting?
Coronary artery bypass grafting (CABG) is a surgical procedure designed to treat severe coronary artery disease. When plaque buildup blocks or narrows the coronary arteries, it can reduce blood flow to the heart muscle, leading to chest pain, fatigue, or more serious heart conditions. A CABG procedure helps restore healthy blood flow, improving heart function and quality of life.
At Mass General Brigham, patients benefit from a network of world-class cardiovascular care. Call us at 833-642-2863 to schedule an appointment with a cardiologist or cardiac surgeon near you. Our specialists are here to provide expert care tailored to your needs.
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Why you may need coronary artery bypass grafting
If you’ve been diagnosed with coronary artery disease, your doctor may recommend a coronary artery bypass graft procedure, commonly called heart bypass surgery. Coronary artery bypass grafting is often recommended in situations where blood flow to the heart is severely restricted.
You may need a CABG if:
- You have severe chest pain
- Multiple coronary arteries are blocked
- The left main or left anterior descending coronary artery is significantly narrowed or blocked
- Medications or nonsurgical treatments, like percutaneous coronary intervention (PCI), haven’t worked
- Angioplasty or stent placement hasn’t resolved the issue
How is CABG surgery performed?
Before undergoing CABG surgery, your doctor will perform a thorough evaluation to ensure you’re in the best possible condition for the procedure. This will include a physical exam, blood tests, and imaging studies as necessary.
The procedure for CABG surgery includes several steps:
- Anesthesia and intubation: You’ll receive anesthesia to keep you asleep and comfortable throughout the procedure. During this time, your care team will insert a breathing tube and connect you to a ventilator, which helps you breathe during the CABG procedure. In most cases, you’ll also be connected to a heart-lung machine, which temporarily takes over the role of circulating blood and oxygen while your surgeon pauses your heart to perform the surgery safely.
- Harvesting grafts: Your surgeon will carefully remove healthy blood vessels from another part of your body, such as the chest wall, arms, or legs, to use as grafts. These vessels bypass the blocked arteries and restore blood flow.
- Heart bypass surgery: During CABG surgery, your surgeon will attach one end of the harvested graft to the artery beyond the blockage and the other end to the aorta or another source of arterial blood. This new pathway allows blood to flow around the blockage.
Alternative treatment options to CABG
Your doctor may recommend alternative treatments to CABG surgery depending on factors like your age, overall health, and the location and severity of your coronary artery disease. These alternatives aim to provide effective care while minimizing risks or recovery time.
- Off-pump coronary artery bypass: In an off-pump bypass surgery, your surgeon performs the procedure while your heart continues to beat rather than using a heart-lung bypass machine. This approach may be recommended for older adults or individuals with pre-existing medical conditions that increase the risk associated with using a heart-lung machine. This procedure can facilitate a minimally invasive approach.
- Minimally invasive direct coronary bypass: Rather than opening the chest with a large incision, the surgeon makes small incisions to access the heart. This variation of CABG surgery is often performed when blockages are limited to the arteries at the front of the heart.
- Hybrid coronary revascularization: This less invasive approach combines traditional coronary artery bypass grafting with percutaneous coronary intervention (PCI), a nonsurgical method of treating blockages using a stent or stents. Hybrid coronary revascularization is less invasive and can be a good option for certain patients, depending on the location and severity of the blockages.
- Coronary endarterectomy: Your surgeon may use this procedure if the main vessel (left anterior descending) is diffusely diseased and cannot be bypassed using traditional techniques.
What to expect after CABG surgery
Since CABG is an open-heart surgery, you will need to stay in the hospital for a few days, typically ranging from three to seven days, so your care team can closely monitor your recovery. They will check your vital signs, including your heart rhythm and breathing, to make sure everything is progressing as expected. They will also be there to address any complications and support you through the initial stages of healing.
Recovery from a coronary artery bypass graft
You’ll work with a team of specialists, including dietitians, exercise therapists, and counselors, who will support you in your CABG recovery.
They will guide you through:
- Creating a heart-healthy eating plan
- Building a safe and effective exercise routine
- Addressing emotional or mental health challenges related to your surgery and recovery
As you recover from CABG surgery at home, your doctor may prescribe medications to help manage pain, reduce the risk of blood clots, and prevent other potential complications. To support your recovery, your care team will likely recommend a cardiac rehabilitation program. This program is designed to strengthen your heart and body.
Your doctor will also recommend that you avoid driving for a month and refrain from lifting heavy objects for at least six weeks. You will be encouraged to stay active, such as walking one to two miles every day about four weeks after surgery.
FAQs about coronary artery bypass graft surgery
Yes, coronary artery bypass grafting is a type of open-heart surgery. The traditional approach involves accessing the heart by opening the chest cavity, allowing the surgeon to perform the procedure directly on the heart.
Coronary artery bypass grafting is the most durable treatment for coronary artery disease. The lifespan of each graft depends on factors like the quality of the blood vessel used and the vessel being bypassed. At Mass General Brigham, we focus on using arterial blood vessels, which clinical trials have shown to be more effective and long-lasting.
