Coronary/Heart Bypass (CABG)

Coronary artery bypass grafting or "CABG" is one of the most performed "open heart" operation in the world. Cardiothoracic surgeons perform the procedure to bypass blockages or obstructions of the coronary arteries.

The coronary arteries are the blood vessels that supply the heart with oxygen and nutrients. The heart relies on these fuels to constantly to pump blood through the body. The heart never rests like the other muscles in the body, and it demands a constant supply of fuel day and night. If you have coronary artery disease, your coronary arteries become narrowed or blocked, restricting the supply of oxygen and nutrients. This starves the heart of oxygen, which causes angina. Angina is the feeling of chest pain, chest tightness and sometimes breathlessness or choking.

A Heart bypass can bypass the blocked arteries so that blood can flow more easily. A new blood vessel (a graft) is attached from your aorta (your main artery) to a point in the coronary artery beyond the blockage. Your graft(s) can be created from blood vessels taken from your chest wall, leg or arm.

A Coronary artery bypass grafting (CABG) doesn't cure coronary artery disease so it's possible for blockages to recur in both the grafts and other blood vessels, but it does improve symptoms such as angina.

A heart bypass procedure takes around three hours, but may take longer depending on how many grafts need to be done.

If blood vessels from your leg or arm are being used for grafts, your surgeon will remove and prepare these first. Your surgeon will then make a cut, about 25cm (10 inches) long, down the middle of your breastbone (sternum) and will open your ribcage to reach your heart.

Your surgeon may attach the new grafts while your heart is still beating, but it's more common to temporarily stop your heart. Your blood is then diverted to a heart-lung (bypass) machine. This takes over from your heart and lungs to add oxygen to your blood and maintain your circulation.

The grafts will be attached and your heart will be restarted. Your sternum will be rejoined using wires and the skin on your chest will be closed with dissolvable stitches.

The procedure takes around three hours, but may take longer depending on how many grafts need to be done. After a CABG, you will be taken to the intensive care unit (ICU) and will be closely monitored for about 24 hours before you go back to your ward. When you wake up you will be connected to machines that record the activity of your heart, lungs and other body systems. These might include a ventilator machine to help you breathe.

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