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
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
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
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
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).
After CABG surgery, the patient recovers in the
intensive care unit (ICU).
Many patients can go home about 3 to 6 days after
It will take another 4 to 6 weeks for the patient
to feel stronger and resume his or her normal activities.
American Heart Association 800/AHA-USA-1
Cardiothoracic Surgery Networkhttp://www.ctsnet.org/innovation/beatingheart
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
Parmet S, Lynm C, Glass RM. Coronary Artery Bypass Grafting. JAMA. 2004;291(15):1922. doi:10.1001/jama.291.15.1922