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Back to Cardiovascular Procedures
Coronary artery bypass surgery
A coronary artery bypass graft (CABG) or heart bypass is a surgical
procedure performed in patients with coronary artery disease, for the
relief of angina and reduction in the risk of heart attack. Veins or
arteries from elsewhere in the patient's body are grafted from the
aorta to the coronary arteries, bypassing blockages caused by
atherosclerosis and improving the blood supply to the myocardium
(heart muscle).
First, the sternum is cut and the chest opened (a procedure known as
"cracking the chest". The heart is usually stopped and the patient is
connected to a bypass machine, which takes over the heart's functions
for the duration of the operation. Blood vessels are harvested from
elsewhere in the body for grafting.
Typically, the saphenous vein from the leg and the left internal
mammary artery (LIMA) are used for the bypass. Veins used either have
their valves removed or are turned around so that the valves in them
do not occlude blood flow in the graft. LIMA grafts are longer-lasting
than vein grafts, both because the artery is more robust than a vein
and because, being already connected to the aorta, the LIMA need only
be grafted at one end. For this reason, the LIMA is usually grafted to
the left anterior descending artery (LAD), which supplies the left
ventricle, the part of the heart that pumps oxygenated blood around
the body. Alternatively, an artery such as the radial artery from the
arm, may be used in place of a vein. This is believed to prolong the
life of the grafts but this has yet to be proven.
Prognosis following CABG depends on a variety of factors, but
successful grafts typically last around 10-15 years.
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