What is CABG? Coronary artery bypass grafting (CABG) is open-heart surgery to bring back blood flow to parts of your heart. You need this when your heart can't get enough blood due to artery blockages causing heart muscle cells to begin to die. CABG builds a bypass for blood to reach areas of your heart that need more blood. A bypass works like a detour for your blood to go around an obstacle. Surgeons take a blood vessel from your leg, arm, or chest.

How should I get ready for this procedure? CABG is a big operation. You need to undergo several tests before heart bypass surgery. These tests help your doctor determine if it's safe for you to have this operation and decide if you need it. Tests might include, but aren't limited to, the following:

• Electrocardiogram (ECG or EKG)
• Echocardiogram
• Exercise stress test
• Nuclear cardiac stress test
• Cardiac catheterisation
• X-ray or CT scan angiography
• Coronary calcium scan (CT Coronary Angiogram)
• Blood and urine tests
• Carotid Vertebral Artery Doppler

What happens during CABG? During coronary artery bypass grafting, your doctor will:

• Use a heart-lung machine to manage your heart and lung functions, although some surgeries happen off-pump, meaning without the machine.
• Give you anesthesia to keep you unconscious and free from pain during the surgery.
• Make an incision in the middle of your chest.
• Separate your breastbone (sternum) in half (in certain cases, a doctor makes a smaller cut between your left ribs or uses a robot-assisted approach) to access your heart
• They take a healthy blood vessel from another area of your body
• Connect this bypass vessel to form a different route around the clogged artery, which brings blood back to the heart.
• Get your heart beating again (if they used a heart-lung machine) and restore your blood flow.
• Sternal halves are brought in place and secured with wire to allow it to heal.
• Stitch up the incision in your chest with sutures. (Absorbable)

Types of CABG Doctors can perform CABG in several ways:

• Off-pump CABG: This method doesn't need a heart-lung bypass machine. The surgeon operates while your heart keeps beating.
• Minimally Invasive CABG: This approach uses small incisions. The surgeon reaches your heart through spaces between your ribs.
• Robot-assisted CABG: A surgeon controls a robot to do the surgery. This technique uses smaller cuts and avoids opening your chest bone.
• Hybrid procedure: This involves robot-assisted CABG on at least one artery. For other clogged blood vessels, a surgeon might use other methods like putting in stents to keep them open.

Benefits CABG has several benefits. These include:

• A long history of use: Doctors have performed CABG since the 1960s. Improvements have made bypass surgery a dependable way to restore blood flow to your heart.
• Best choice for blockages in multiple arteries: CABG often works best if you have multiple blocked arteries in your heart. It also works best for blockages in specific locations/inaccessible for angioplasty.
• Lower risk of follow-up procedures: Angioplasty is the main alternative to CABG. In many cases, it has a higher chance of needing a follow-up procedure than CABG surgery and has less lasting effects.

Complications Possible risks include:

• Uneven heart rhythms (arrhythmias)
• Blood loss
• Germs getting in (infection)
• Feeling mixed up or out of it
• Kidney issues
• Blood clot in the brain (stroke)
• Heart attack

When should I contact a Doctor You should go to the hospital right away if you have any of these:

• Pain in the chest
• Difficulty breathing
• Feeling dizzy or light-headed
• Passing out
• Rapid or irregular heartbeats
• Drooping of the face
• One side of your body feels weak
• Speech becomes unclear or hard to understand
• Feeling hot or shivery
• Heart or breathing rate speeds up