Coronary Artery Bypass Grafting (CABG): Procedure Overview

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

Indication

Severe coronary artery disease (CAD) with significant blockages causing angina, heart attack risk, or reduced heart function.

Procedure

1. Surgeon harvests a healthy conduit: saphenous vein (leg), internal mammary artery (chest), or radial artery (arm).
2. Heart may be stopped (on-pump, with cardiopulmonary bypass) or beating (off-pump).
3. Graft is anastomosed: one end to aorta (or other arterial source), other end to coronary artery distal to blockage.
4. Multiple grafts may be placed (double, triple, quadruple bypass).

Outcomes

• Relieves angina in >90% of patients.
• Improves survival in specific high-risk anatomy (left main, multi-vessel disease with reduced EF).
• Risks: stroke, infection, bleeding, arrhythmia, cognitive changes (usually temporary).
• Recovery: 5–7 days hospitalization; 6–12 weeks to full activity.

CABG is a major but well-established procedure with durable results when combined with lifestyle modification and medical therapy.