Coronary Artery Bypass Surgery
(Also called: coronary artery bypass grafting (CABG), coronary bypass surgery)
Purpose
Coronary artery bypass surgery is used to treat symptoms of coronary artery disease that do not improve with medication, lifestyle changes, or minimally invasive procedures, such as angioplasty. During the surgery, blood vessels are removed from another part of the body and used to reroute the heart’s blood supply past blocked coronary arteries, allowing oxygen-rich blood to reach the heart.
The surgery is performed through a chest incision. The surgeon will decide if the surgery will be done with or without the use of a heart-lung bypass machine. The heart-lung bypass machine takes over for the heart and lungs during the operation. This allows the heart to be temporarily stopped so that the surgeon can more easily work on it. In some cases, surgery is done off the bypass machine. With this approach, special surgical devices are used to hold still portions of the heart during the surgery.
Some patients may undergo minimally invasive off-pump coronary bypass surgery via a smaller incision in the rib cage. This is known as minimally invasive cardiac surgical coronary artery bypass graft (MICS CABG).
Description
- Blood tests, an electrocardiogram, and chest X-rays are done before the procedure.
- A doctor asks the patient to provide informed consent. This is required before the procedure can be performed.
- The patient is taken by stretcher to the Cardiac Operating Room.
- The patient is placed under general anesthesia and remains unconscious throughout the operation
- Once the patient is unconscious, a tube is inserted into the windpipe and connected to a machine called a respirator, which takes over breathing. A thin tube called a catheter is inserted into the bladder to collect any urine produced during the operation.
- Incisions are made through the patient’s chest and breastbone to allow the surgeons access to the heart.
- If the surgeon decides that an on-pump procedure is the best option for the patient, the patient is connected to a heart-lung machine (also called a heart-lung bypass machine), which pumps the patient’s blood through the body during the surgery.
- Once the heart-lung machine is pumping blood, the patient’s heart is temporarily stopped.
- Healthy blood vessels are taken from the patient’s chest, leg, arm, or elsewhere in the body.
- These healthy blood vessels are connected to the heart to let blood flow around the blocked portions of the heart’s arteries.
- Once the new vessels are connected, the heart is restarted and all incisions are closed.
- The patient stays in the Cardiac Surgery Intensive Care Unit (CSICU) for 24 hours or until intensive care is no longer required.
- When medically ready (usually within one to two days), the patient is moved to a regular hospital room. The average hospital stay after coronary artery bypass surgery is five to seven days.
Patient Instructions
Patients should bring all medications (including non-prescription drugs and supplements) with them to the hospital.
Patients should not eat or drink after midnight the night before surgery.
Additional Information
Patients and their families are asked to attend a class prior to discharge in order to obtain post-operative care instructions. They will also receive the Cardiac Surgery Patient Guide with information about their specific surgery. A nurse will review with the patient and family members all medications the patient will be taking once discharged.
