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JAMA Patient Page
April 21, 2004

Coronary Artery Bypass Grafting

JAMA. 2004;291(15):1922. doi:10.1001/jama.291.15.1922

Coronary artery bypass grafting (CABG) is a surgical procedure that uses veins from the leg or arteries from another part of the body to reroute blood around a blockage in the arteries that supply the heart with blood and oxygen (coronary arteries). The April 21, 2004, issue of JAMA includes an article that compares the results of CABG surgery with and without use of a heart-lung bypass pump. The heart-lung bypass pump takes over pumping blood and allows surgeons to stop the heart while they attach the new blood vessels. Without the heart-lung bypass pump, the heart continues to beat throughout the operation.

CORONARY ARTERY DISEASE

  • In persons with coronary artery disease (CAD), yellow 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.

CABG SURGERY PROCEDURES

  • 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. This will provide the surgeon with a "roadmap" of the coronary arteries.

  • During surgery, the chest is opened by cutting down the center of the sternum (breastbone).

  • 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 suction devices ("beating heart"
    or "off-pump" CABG).

  • A blood vessel from another part of the body (vessel graft) 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).

RECOVERING FROM CABG 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.

FOR MORE INFORMATION

INFORM YOURSELF

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 percutaneous coronary intervention was published in the February 11, 2004, 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. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.

TOPIC: HEART DISEASE

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