Coronary Artery Bypass Grafting, commonly known as CABG (pronounced 'cabbage') or heart bypass surgery, is a major surgical treatment for selected patients with coronary artery disease.
What is Coronary Artery Disease?
Coronary arteries are the essential blood vessels that supply oxygen-rich blood directly to your heart muscle. Over time, fatty deposits and plaque can build up inside these arteries, causing them to become narrow or blocked. This reduces blood flow, which can lead to chest pain (angina), shortness of breath, or even a heart attack.
How Does CABG Work?
During a bypass operation, a cardiac surgeon takes a healthy blood vessel—often from your leg (saphenous vein), chest (internal mammary artery), or arm (radial artery)—and connects it above and below the blocked artery. This creates a brand-new pathway (a bypass) for blood to flow freely, restoring vital oxygen supply to the heart muscle.
On-Pump vs. Off-Pump CABG
Depending on the patient's condition and surgical requirements, bypass surgery can be performed in two ways:
- On-Pump CABG (Conventional): The heart is temporarily stopped, and a heart-lung machine takes over the work of circulating blood and oxygen throughout the body. This allows the surgeon to operate on a still heart.
- Off-Pump CABG (Beating Heart Surgery): The surgeon operates while the heart continues to beat normally, using specialized stabilizing equipment to hold the specific area of the heart still during the bypass.
When is CABG Recommended?
The decision to perform bypass surgery is made after careful clinical assessment and tests (such as a coronary angiography). It may be recommended if:
- Multiple coronary arteries are narrowed or blocked.
- The main artery supplying the left side of the heart (left main coronary artery) is severely blocked.
- Your heart muscle is weak, and bypass surgery will help improve its pumping ability.
- Stents (angioplasty) have failed or are not medically suitable.