The sternum is open to allow access to the heart and then is closed with metal wires once the operation has been completed. This surgery is usually performed with the heart stopped, necessitating the usage of cardiopulmonary bypass; techniques are available to perform CABG on a beating heart, so-called "off-pump" surgery.
Arteries or veins from elsewhere in the patient's body are grafted to the coronary arteries to bypass atherosclerotic narrowing and improve the blood supply to the coronary circulation supplying heart muscle. One or more arteries can be bypassed during the operation, and is termed as double or triple heart bypass surgery.
Coronary Artery Bypass Grafting (CABG) is an operation that restores proper flow of oxygenated blood to your heart re-routing blood flow around your blocked coronary artery. In the procedure, a transplanted piece of vessel, called a graft, allows blood to "bypass" the blockage in your artery.
Grafts are created using healthy blood vessels taken from other parts of your body. Depending on your condition, your physician will use a vessel from your chest or remove a section from your leg. Your internal mammary arteries are close to your heart. In a CABG procedure using mammary arteries, one end of the vessel remains attached to the blood source while the other end is rerouted and connected beyond the blockage in your coronary artery.
In a procedure using vein from the leg, a part of the vessel is removed from your leg. The resulting graft is like a small section of hose. One end of the graft is connected to your aorta, the large artery that feeds your coronary arteries, and the other end is connected to a point on your coronary artery just beyond the blockage. This creates a detour for oxygen-rich blood to reach you heart.
The vessels used for grafts are redundant which means your body can compensate for their loss. If you are suffering from CAD, vessels taken from other parts of your body are more valuable to you when they're used as grafts. Your leg will still function without a section of saphenous vein and your chest will receive blood without an internal mammary artery.
The number of bypasses performed during the surgery will depend on your condition and the number of blocked arteries. Three to five bypasses are common during a procedure. Nonetheless, some surgeries require as many as nine bypasses. CABG can take six to twelve hours followed by a few days of recovery in intensive hospital care.
Coronary Artery Bypass Grafting is a treatment option when other measures fail, when there are multiple blockages in your arteries, or when critically blocked coronary arteries put you at imminent risk for a heart attack. CABG is a major surgery and is therefore associated with some risks; however, the procedure has become very common.
The patient is monitored in the intensive care unit normally for a day following the procedure, a stay of 4 to 6 days following this in the hospital.
The patient is advised breathing exercises and basic activities that help speed up recovery