Coronary/Heart Bypass (CABG)

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Coronary/Heart Bypass (CABG)

A Coronary/Heart Bypass or Coronary Artery Bypass Graft (CABG) is a surgical procedure used to treat coronary heart disease.

A little background:

Like all organs in the body, the heart needs a constant supply of blood. This is supplied by 2 large blood vessels called the Left & Right Coronary Arteries. Over time, these arteries can become narrowed and hardened by the build-up of fatty deposits called plaques. This process is known as atherosclerosis. People with atherosclerosis of the coronary arteries are said to have coronary heart disease.

When an artery becomes narrow, blood struggles to get to the heart. Thus, this operation involves creating a graft, or a new pathway for the blood so it can start flowing back to the heart muscle again. It diverts blood around narrowed or clogged parts of the major arteries to improve blood flow and oxygen supply to the heart.

What does the procedure involve?

The procedure is performed under general anaesthesia. 

The surgeon will make an incision down the middle of your chest and carefully divide your breastbone (sternum) to get to your heart. 

The surgeon use:

  • Internal mammary arteries – chest arteries
  • Radial arteries – arteries from the arm
  • Veins from the leg

To create the graft. Some patients will only need one graft but it’s more common for people to need two, three or four. These veins and arteries can be removed without any damaging effect on your circulation.

On pump/off pump surgery

On pump

CABG surgery has been done over the years using a special heart and lung bypass machine. This machine takes over the work of the heart and lungs and means that oxygen-rich blood can continue to flow around the body while the heart itself is repaired. 

Off pump

Off pump (also known as the octopus procedure), is a technique where CABG surgery is done without using a heart and lung bypass machine. This technique involves attaching the grafts while the rest of the heart continues to work as normal. 

The surgery is done just like it would if it were a standard CABG, and the recovery afterwards is very similar. Your surgeon will consider your health and medical condition and then chat with you about which procedure is best for you. After your bypass graft, the surgeon will re-join the breastbone using stainless steel wires, and the incision in your chest will be sewn up using dissolvable stitches.

Most people will need to stay in hospital for about 6 to 8 days after having a coronary artery bypass graft.

This is a big operation. It is not terribly painful, but there is pain afterwards. Usually the chest, back, neck, shoulders and legs can hurt, but this is easily treated with standard painkillers. The operation also makes patients feel tired and lacking in energy for the first few weeks.