What Is CABG?
CABG is a type of open-heart surgery specialists use to treat a heart attack when arteries that bring blood to the heart narrow or get blocked.
Cholesterol and fatty deposits known as plaque build up on the inner walls of your arteries and can block or restrict your blood flow. This is called atherosclerosis.
What Does CABG Stand For?
CABG (sometimes pronounced cabbage) stands for coronary artery bypass graft, also known as coronary artery bypass surgery.
What Is CABG Surgery?
CABG creates a new pathway around a blocked artery, using grafts from an artery or vein taken from another part of your body.
Your surgeon attaches one end of the graft to the large artery that comes out of the heart (aorta). The other end of the graft is attached to your artery at a point below the blockage. This allows blood to bypass the blockage, restoring normal flow to your heart.
Arteries/Veins for CABG Surgery
Grafts may come from arteries in your chest, arm, and stomach or veins in your legs.
The left mammary vein in your chest, or the saphenous vein in your leg are common choices for this procedure.
What to Expect During CABG Surgery
You and your treatment team will discuss specifics of your surgery, including the best way to prepare, what you may be able to eat or drink, and medications you can take.
If your specialist and you decide on this surgery, your treatment team will provide anesthesia before the surgery begins, causing you to sleep deeply and painlessly during the operation. You won’t remember the operation.
Your body continues to breathe with the help of a ventilator, and we monitor your vital signs continuously throughout the procedure.
Based on your needs, you may have more than one bypass done during surgery.
First, your surgeon performs a procedure to remove the arteries and/or veins that will be used for the grafts.
Next, your surgeon makes an incision in the center of your chest. Your breastbone (sternum) is split in half, giving the surgery team access to your heart.
On-Pump CABG
In an on-pump procedure, we stop your heart temporarily to connect the grafts. Your blood will continue to flow normally using a heart-lung machine. This machine allows the heart to stop beating, but blood flows to and from the vessels in your body using a series of tubes and clamps.
Once your heart is stopped, your surgeon attaches one end of the graft to the large artery that comes out of the heart (aorta).The other end of the graft is attached to your artery at a point below the blockage.
After your surgeon completes the graft, they will check to make sure blood is flowing properly around your blocked artery.
When we have completed all the grafts you need, we restart your heart and remove the heart-lung machine.
Off-Pump CABG
In some cases, specialists can perform CABG while your heart is still beating. You will not need a heart-lung machine, so the procedure is called off-pump surgery. This is also known as beating heart surgery.
Your surgeon stabilizes individual areas of the heart and connects the graft while the rest of your heart circulates blood to your body.
After we complete the graft, we make sure blood is flowing properly around your blocked artery. This method is more difficult and we use it only for special cases.
Completing CABG Procedures
To complete the surgery, we repair your breastbone using wires the size of a paperclip to hold it shut. Your doctor will insert tubes into your chest to drain fluid, then sew the incision in your skin over the sternum.
You may also have two or more small wires on your chest that are temporarily attached to the surface of your heart. We can use these wires to control your heartbeat, if needed, as you recover.
CABG Procedure Time
CABG surgery typically lasts three to six hours. The procedure time is individual to each patient depending on factors such as the number of bypasses and your overall health.
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After CABG Surgery
Following your surgery, we will take you to the cardiovascular intensive care unit, before moving you to a private room. Your recovery team will closely monitor your vital signs and medication. You may have an IV in your arm and neck to give you medication for your heart and blood pressure.
You’ll have a breathing tube, which we remove as you begin to breathe on your own. Your recovery team will teach you how to breathe deeply and cough to clear fluid buildup in your lungs.
You will feel sore and tender for several days, but can take pain reliever as recommended by your doctor.
You can get up and walk, visit with family, and eat solid food soon after your surgery—usually within 24 hours.
Your treatment team will give you exercises and outline more information to help you recover, both in the hospital, and at home.
CABG Recovery Time
Most patients stay in the hospital for about a week before going home.
Your doctor and nurses will give you specific instructions on how to care for your incision site, what medications to take, and other physical therapy or general recommendations.
Your recovery will take six to eight weeks. With your doctor’s approval, you’ll be able to resume most normal activities within four to six weeks.
Follow-Up After Surgery
It’s important that you discuss follow-up care with your doctor. Your treatment team will provide specific instructions on caring for your incision site and what medications to take.
Cardiac Rehabilitation
Most patients begin cardiac rehabilitation within two weeks of surgery. We closely supervise your rehabilitation to help your heart become healthy and strong after surgery.
Your doctor may recommend healthy lifestyle changes. We encourage you to walk and do light daily activities. You cannot lift objects over five to ten pounds for up to eight weeks.
We will schedule you for a follow-up visit two weeks after your surgery. At this appointment, your doctor will remove your stitches. You’ll also have a chest x-ray and receive additional lab testing to make sure the CABG procedure was successful.
You can check in with your cardiologist in four to six weeks to adjust your medication and discuss any other needs.
Results & Outcomes for CABG Surgery
Most patients see improvements and remain symptom-free for 10 to 15 years after CABG surgery.
Your individual outcomes, however, will depend on your overall health and lifestyle. You and your doctor will set up a plan to keep you healthy. This may include medication, regular exercise, dietary changes, or other positive habits.