Coronary Artery Disease (CAD) and Angina and Coronary Artery Bypass Graft (CABG)

A coronary artery bypass graft (CABG) is open-heart bypass surgery done to help relieve symptoms of heart disease, such as angina. However, it does not cure heart disease. You still must maintain a healthful lifestyle that includes maintaining or achieving a healthy weight, eating a low-fat diet, not smoking, and possibly, taking medications.

CABG surgeries have typically been done with the patient on cardiopulmonary bypass (CPB), which immoblizes the heart and keeps it still. Newer methods utilize a "beating heart" procedure, whereby CPB is avoided and the surgery is performed with the heart still beating. While the results are encouraging, it is a relatively new procedure. Talk to your doctor about what options are available, and which one might be best for you.

During a CABG procedure, a blood vessel (vein) is taken from the leg or chest or wrist and grafted into a diseased artery, bypassing the blocked area. If more than one area is blocked, a bypass can be done for each area (leading to double, triple, or quadruple bypass). The blood can then go around the obstruction to supply the heart with enough blood carrying oxygen to relieve chest pain (angina).

Read more details about Coronary Artery Bypass Graft (CABG).

According to a review of 23 studies, patients who received CABG had more angina relief and less need for another, similar procedure than those who received percutaneous coronary intervention (PCI). PCI involves techniques using balloon angioplasty or coronary stenting.

An open CABG is considered major surgery, using general anesthesia, and the risks and benefits should be carefully discussed with your doctor.

If you are planning to have a CABG, your doctor will review a list of possible complications, which may include:

• Infections
• Blood clots
• High or low blood pressure
• Bleeding
• Stroke
• Damage to other organs, such as the kidneys
• Irregular heart rate
• Death

Some factors that may increase the risk of complications include:

• Lung disease, especially chronic obstructive pulmonary disease (emphysema)
• Prior heart attack or bypass surgery
• Advanced age
• Surgical urgency
• Obesity
• Diabetes
• Smoking
• High blood pressure
• Thyroid disease