What is Involved in a Coronary Artery Bypass Grafting (CABG) Procedure?
If your cardiologist feels that your coronary disease is not amendable to angioplasty or your coronary disease is accompanied with other diseases such as diabetes you could be referred for Coronary artery bypass grafting. This is a more invasive procedure to improve blood flow to the heart. While more invasive results especially with more advanced, multi vessel disease combined with diabetes, have improved results long term over angioplasty and stenting.
The procedure itself requires the surgeon to make an incision over the breast bone. The sternum or breast bone is then divided to allow the surgeon access to the heart. An Artery is often harvested from the chest wall to perform one of the bypasses. While this is being done a vein is taken from the leg utilizing video technology through one small 1 1/2 inch incision around the knee. These veins and arteries and sewn to the coronary arteries just past the blockages. This allows blood to flow around the blockage. To accomplish this, the surgeon then places the patient on a bypass machine which empties blood from the heart, filters and oxygenates the blood, then returns it to the patient. This allows the surgeon to stop the heart and perform the bypasses on a still heart. Once the bypasses are performed the patient is taken off of the bypass machine and the sternal bone is repaired and the patient closed. The procedure in its entirety often averages around 2-3 hours. The patient is then transferred to an intensive care unit for recovery.
Minimally invasive options- In certain instances it is possible to the bypass operation through a small three inch incision in the left chest. This is usually performed when only one or two bypasses are required. The artery is taken off of the inside chest wall with the help of a robot. This allows the surgeon improved visualization and greater dexterity, while causing less trauma to the patient. Another advantage to this operation is that it is often performed without using the bypass machine.