Although it’s pronounced just like the vegetable, the “cabbage” surgical procedure is actually referred to as CABG, or coronary artery bypass grafting. During the procedure, a surgeon creates a new passage for blood flow in the coronary arteries. Typically, a CABG procedure is necessary when something severely obstructs the normal flow of blood to the heart.
Types
An on-pump CABG surgery uses a heart-lung machine -- or cardiopulmonary bypass machine -- to still the heart. During the surgery, this machine takes over the functions of the heart and lungs. Once the machine begins effectively circulating blood through the body, the patient’s heart is stopped while the surgeon completes the surgery.
During an off-pump CABG surgery – or beating heart CABG – the patient’s heart remains beating throughout the surgery. Instead of stopping the heart entirely, the physician uses specialized equipment to stabilize only the area of the heart being repaired.
The minimally invasive coronary artery bypass can be used for patients requiring bypass grafting of a left internal mammary artery to the left anterior descending artery. This type of surgery requires a smaller incision, allowing for a reduced risk of infection, minimized bleeding and a smaller scar.
Procedure
General anesthesia is required for a CABG. Once the patient is successfully anesthetized, the surgeon removes arteries from another location in the patient’s body. According to the Cleveland Clinic, the internal mammary arteries near the midline of the chest are most commonly used. However, arteries from the arm, leg or stomach might also be used. Once these arteries are prepped, the surgeon makes a small incision just below the coronary artery blockage. One end of the new artery is attached to the blocked coronary artery, while the other end is attached to the heart’s aorta. This same procedure is repeated for all blocked coronary arteries. Typically, the CABG surgery takes three to five hours, depending on the number of coronary arteries needing attention.
Causes
Coronary artery bypass grafting allows for improved blood flow to the heart in patients with coronary heart disease – or coronary artery disease. CAD develops when a thick, sticky substance known as plaque accumulates along the inner walls of the coronary arteries. Since these arteries supply oxygen-rich blood to the heart, the blocked passage results in decreased blood flow to the heart and an increased risk of having a heart attack.
Recovery
After attachment of the new arteries, temporary pacing wires and a chest tube are inserted into the chest before the incision is closed. If necessary, a pacemaker might also be attached to the pacing wires. Typically, CABG patients spend one to two days in the intensive care unit, followed by three to five days in a hospital step-down unit before discharge. Full recovery can take up to 10 weeks and your physician will provide you with specific recovery guidelines for your exact condition. Your physician helps you determine how to care for your incision and when you can drive, return to work and resume physical activity after your surgery.
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