Coronary Artery Bypass Grafting (CABG): Surgical Procedure Overview

Understanding CABG Surgery

Coronary artery bypass grafting (CABG) is a life-saving surgical intervention that restores blood flow to the heart muscle when atherosclerotic plaque severely narrows or blocks the coronary arteries. By creating new pathways for oxygen-rich blood, CABG relieves ischemia and reduces the risk of heart attack.

How the Procedure Works

Surgeons harvest healthy blood vessels from elsewhere in the patient's body—most commonly the internal mammary artery (from the chest wall), saphenous vein (from the leg), or radial artery (from the forearm). These grafts are then surgically attached to the coronary artery distal to (beyond) the blockage, effectively bypassing the obstructed segment.

Graft Selection and Longevity

• Internal Mammary Artery (IMA): Gold standard with 90%+ patency at 10 years; preferred for the left anterior descending artery.
• Saphenous Vein Graft (SVG): Readily available but higher long-term occlusion rates (~40-50% at 10 years).
• Radial Artery: Intermediate patency; useful for additional targets when IMA is unavailable.

The number of bypasses performed (single, double, triple, quadruple) corresponds to the number of coronary arteries grafted. Modern techniques include off-pump (beating heart) CABG and minimally invasive approaches for select patients.