Coronary artery bypass graft surgery (CABG), commonly known as bypass surgery, is a surgical procedure to improve blood flow to the heart in people with severe coronary artery disease (CAD). Here’s a breakdown:   

Understanding the Need:

  • CAD occurs when plaque builds up inside the coronary arteries, narrowing or blocking them.   
  • This reduces blood flow to the heart muscle, causing chest pain (angina), shortness of breath, or a heart attack.   
  • CABG creates new pathways for blood to flow around the blockages.   

How it Works:

  • During CABG, a healthy blood vessel is taken from another part of the body (e.g., the leg, chest, or arm).   
  • This vessel is then grafted (attached) to the coronary artery, bypassing the blocked section.   
  • This creates a new route for blood to flow to the heart muscle.   
  • The surgery can involve multiple bypasses, depending on the number of blocked arteries.   

Types of CABG:

  • Traditional CABG:
    • Requires a sternotomy (opening the chest by dividing the breastbone).   
    • The heart is often stopped, and a heart-lung machine is used to circulate blood.   
  • Off-pump CABG (OPCAB):
    • Performed on a beating heart, without the use of a heart-lung machine.   
    • May be less invasive and have a shorter recovery time in certain cases.
  • Minimally invasive CABG (MIDCAB):
    • Performed through small incisions in the chest.   
    • Often avoids a full sternotomy.
    • May have a shorter recovery period.

Benefits:

  • Relief from angina and other CAD symptoms.   
  • Improved heart function.   
  • Reduced risk of heart attack.
  • Improved quality of life.   
  • Increased survival rate in some patients.

Risks:

  • Like any major surgery, CABG carries risks, including:
    • Bleeding.
    • Infection.
    • Stroke.
    • Heart attack.
    • Kidney problems.
    • Arrhythmias.
    • Cognitive decline.

Clinical Significance:

  • CABG is a well-established and effective treatment for severe CAD.
  • It can significantly improve the lives of patients with debilitating symptoms.   
  • The decision to proceed with CABG is made by a team of cardiologists and cardiac surgeons, based on the individual patient’s condition.