Coronary Artery Bypass Graft (CABG)
Coronary artery bypass grafting (CABG) surgery is a procedure that uses arteries or veins from the body to reroute blood around a blockage in the coronary arteries (the arteries that supply blood and oxygen to the heart).
Indications for CABG
Coronary artery bypass grafting may be performed when:
- Angina (chest pain) and other symptoms can’t be managed with medications
- You are at risk for a heart attack due to diminished blood flow
About the Procedure
During coronary artery bypass grafting, the blockage in the artery is bypassed using a grafted vein, generally from the leg. One end of the vein is sewn to the aorta (the large artery that carries blood from the heart), and the other end is attached to the coronary artery below the point at which it’s blocked. The new channel allows blood to flow to the heart and relieve symptoms.
Traditional bypass surgery is an open-chest procedure that involves making a large chest incision to expose your heart and arteries. It also requires the use of a heart-lung bypass machine, which takes over the role of the heart and lungs during surgery and permits the heart to be stopped to perform the surgery. UC San Diego Health System’s cardiothoracic surgery team is highly experienced in traditional bypass techniques.
Beating Heart Surgery: A Less-Invasive CABG Technique
UC San Diego heart surgeons now offer a less invasive coronary artery bypass grafting procedure that can help reduce complications as well as minimize scarring and improve recovery time. This technique is called beating heart surgery or off-pump coronary artery bypass (OPCAB), and it is performed without the use of the heart-lung bypass machine.
Instead of a heart-lung bypass machine, a stabilizing device is attached to the beating heart to reduce its movement during the procedure. OPCAB can be used to perform several bypass procedures at once.
Benefits of Off-Pump Coronary Artery Bypass
Benefits of beating heart surgery performed without the use of heart-lung bypass include:
- Reduced risk of stroke
- Fewer complications associated with the lungs
- Less need for blood transfusions
- Less injury to the heart muscle
Patient Eligibility for OPCAG
Patients who are at increased risk of complications from cardiopulmonary bypass may be good candidates for off-pump coronary artery grafting. These risks may include having carotid artery stenosis or compromised pulmonary or renal function.
Minimallly Invasive Direct Coronary Artery Bypass
UC San Diego heart surgeons also perform another beating heart procedure known as minimally invasive direct coronary artery bypass (MIDCAB ).
During MIDCAB, several small incisions are used to access the coronary arteries instead of the one large incision (sternotomy) used in traditional CABG surgery.
Which Coronary Artery Bypass Graft is Best?
Each patient is unique, and there is no single answer to this question. At UC San Diego, heart surgeons work with each patient, performing an extensive medical evaluation and considering all possible risks and complications, before making a recommendation on which procedure offers the optimal balance of safety and effectiveness.