Coronary artery bypass grafting (CABG) is a surgical procedure that uses another artery or vein to reroute blood around a blockage in the arteries (coronary arteries) that supply the heart with blood and oxygen. The April 16, 2008, issue of JAMA includes an article about CABG surgery. This Patient Page is adapted from one published in the April 21, 2004, issue of JAMA.
In persons with coronary artery disease (CAD), deposits of cholesterol and fats called plaque form in the coronary arteries. This process is called atherosclerosis (hardening of the arteries).
If plaque continues to build up, blood vessels can become partially or completely blocked so the heart does not receive enough oxygen carried by red blood cells, leading to angina (chest pain) or even a myocardial infarction (heart attack).
CABG surgery may be done to bypass blocked coronary arteries.
Before undergoing CABG surgery, a special dye that can be seen on x-ray film is injected into the coronary arteries while x-rays are taken.
Blood-thinning drugs called anticoagulants are given to help prevent blood clot formation during the operation.
If a heart-lung bypass machine is used, the machine takes over pumping blood for the heart (conventional "on-pump" CABG).
If a heart-lung bypass machine is not used, the heart is positioned and the coronary artery to be bypassed is stabilized with special devices ("beating heart" or "off-pump" CABG).
Another artery or vein is sewn into place so that blood flow can bypass the blockage in the coronary artery. If more than one artery is blocked, more blood vessels will be used to bypass them (called double, triple, or quadruple bypass surgery).
After CABG surgery, the patient recovers in the intensive care unit (ICU).
Many patients can go home about 3 to 6 days after surgery.
It will take another 4 to 6 weeks for the patient to feel stronger and resume his or her normal activities.
American Heart Association
Cardiothoracic Surgery Network
To find this and other JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. A Patient Page on acute coronary syndromes was published in the August 15, 2007, issue.
Sources: American Heart Association; National Heart, Lung, and Blood Institute; Heart Information Network
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724.
TOPIC: HEART DISEASE
Parmet S, Lynm C, Glass RM. Coronary Artery Bypass Grafting. JAMA. 2008;299(15):1856. doi:10.1001/jama.299.15.1856