Coronary Artery Bypass Grafting

The most common form of heart disease is that affecting the coronary arteries. The heart is a strong pump that depends on adequate blood supply to function normally. When atherosclerosis or plaque buildup develop, usually as a result of risk factors including hypertension, elevated cholesterol, smoking, diabetes, and obesity, flow of blood to the heart is reduced. If it is reduced below the heart’s requirements, most patients will develop chest pain. A heart attack may then develop if the reduced flow persists for a period of time.

Patients who develop chest pain should be evaluated by their physician. This may prompt admission to the hospital for further evaluation, which may include a stress test, echocardiogram, and cardiac catheterization. Depending on the patient’s symptoms, heart muscle function, and the extent of coronary artery blockages identified at catheterization, further therapy may involve medications or an intervention to improve blood flow. One of these options is coronary artery bypass grafting (CABG).

• Coronary Heart Disease (CAD)
• Coronary Artery Bypass Grafting (CABG)
• Cardiac Catheterization
• Aortic Stenosis
• Aortic Regurgitation
• Mitral Stenosis
• Mitral Regurgitation
• Endocarditis
• Electrocardiogram (EKG)
• Aortic Aneurysm
• Atrial Fibrillation
• Cardiomyopathy

A CABG is an operation designed to sew bypass grafts into the coronary arteries beyond the areas of blockage. This is commonly performed using a heart-lung machine that provides oxygen and blood flow to the body, while the surgeon actually stops the heart to precisely sew a graft (either an artery from the chest wall or arm, or a vein from the leg) into the artery. Occasionally, this can be performed without stopping the heart.

Following an uneventful CABG, the patient remains in the hospital for about four to five days and then may be discharged home or to a rehabilitation hospital for a few days of additional care. Patients return for an x-ray, EKG and an office visit, usually two weeks after being discharged. Most patients feel quite well after one to two weeks, but need to limit some activities for about six weeks. It is important that patients become involved in supervised cardiac rehabilitation. After six weeks, most patients are able to go back to work.

CABG is a very effective operation to relieve symptoms of chest pain and in most patients, can also improve long-term survival.

Robert M. Bojar, MD