Coronary Artery Bypass Graft

What Is Coronary Artery Bypass Graft (CABG) Open Heart Surgery?

Coronary artery bypass graft (CABG) open heart surgery (also known as coronary artery bypass surgery, heart bypass, and bypass surgery) is most often used on patients suffering from angina or coronary artery disease.   

During coronary artery bypass graft surgery, the patient receives general anesthesia.  The surgeon opens the patient’s chest cavity and examines the heart (the patient usually receives heparin to prevent blood clotting during the grafting process).  Arteries or veins are taken from other parts of the patient's body and grafted to the coronary arteries, bypassing any narrowed arteries and improving the blood supply to the heart.  Generally, this is performed as an “on-pump” surgery, wherein the surgeon must suture cannulae into the heart, and the perfusionist will initiate a cardiopulmonary bypass (using a heart-lung machine).  Then the surgeon clamps shut the aorta, and the perfusionist administers cardioplegia to stop the heart from beating.  In “off-pump” surgery, the surgeon stabilizes the heart with special devices.   

After the surgeon sews the grafted vein to the coronary artery, bypassing the blockage(s), and attaches the other end to the aorta, the perfusionist restarts the heart or removes the stabilizing devices.  Thereafter, the surgeon wires the sternum together and sutures the incisions shut.  In order to reverse the effects of the heparin medication, the surgeon might administer protamine to help thicken the blood.   

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