Coronary Artery Bypass Grafting (CABG): Procedure, Benefits, and Recovery

Coronary artery bypass grafting (CABG) is open-heart surgery that restores blood flow to the heart by bypassing blocked coronary arteries with grafts.

Procedure

1. Grafts harvested: Internal mammary artery (LIMA) (gold standard, best patency), saphenous vein, radial artery.
2. Heart may be stopped (on-pump, with cardiopulmonary bypass) or beating (off-pump).
3. Grafts anastomosed: proximal to aorta (vein) or left subclavian (LIMA), distal to coronary artery beyond blockage.

Indications

• Left main disease.
• Multi-vessel disease (especially with diabetes, reduced LV function).
• Failed PCI / unsuitable anatomy.
• Symptomatic despite optimal medical therapy.

Benefits

• Relieves angina, improves exercise tolerance, quality of life.
• Prolongs survival in high-risk anatomy (left main, 3-vessel + diabetes).
• LIMA-to-LAD graft has >90% 10-year patency.

Recovery

• ICU 1–2 days; hospital 4–7 days.
• Sternal precautions 6–8 weeks (no lifting >10 lbs, no driving).
• Cardiac rehab (Phase II) starts 2–4 weeks post-op.
• Full recovery 6–12 weeks.
• Lifelong medical therapy (antiplatelet, statin, beta-blocker, ACEi/ARB) + risk factor control.

CABG is major surgery but highly effective for appropriate candidates.