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Coronary Artery Bypass Grafting (CABG)

  • What is a coronary artery bypass grafting (CABG)?

    Coronary artery bypass grafting CABG

    Coronary artery bypass grafting (CABG) is a surgical procedure done to bypass (go around) blocked coronary (heart) arteries to restore normal blood flow to the heart muscle.

    In a CABG, doctors will use healthy blood vessels from another part of the body, such as leg veins or internal mammary (breast) arteries, and sew around the blocked part of the blocked artery. This creates an alternate path for the oxygen-rich blood to bypass the blocked part of the coronary artery and restore normal blood flow to the heart.

    Types of coronary artery bypass grafting

    Coronary artery bypass grafting (CABG) can be performed as an on-pump or off-pump procedure.

    On-pump surgery: You will be connected to a heart-lung bypass machine which takes over the functions of the heart and lungs. This allows the surgeon to operate on a still heart.

    Off-pump surgery: Instead of stopping the heart completely, parts of the heart are stabilised using various devices. This allows the surgeon to proceed with the operation on the stabilised section while allowing the rest of the heart to beat and function normally.

    Minimally invasive coronary artery bypass grafting is also performed off-pump. In this procedure, small incisions are made, allowing surgical instruments to be inserted. The operation is then performed using a video feed.

  • Coronary artery bypass grafting (CABG) is performed to restore blood flow to the heart. This is sometimes needed if a person has severe coronary artery disease, which means that the coronary arteries have hardened and narrowed from the build-up of fatty deposits known as plaque.

    Plaque build-up restricts blood flow to the heart muscles, and a complete blockage results in a heart attack.

    Coronary artery bypass grafting (CABG) creates a new pathway around these blockages. This allows blood to flow normally, reducing symptoms of coronary heart disease such as chest pain and lowering the risk of a heart attack.

  • Preparing for a coronary artery bypass grafting

    To prepare for coronary artery bypass grafting, your doctor may recommend several tests such as blood tests, a chest X-ray, electrocardiogram or angiogram to confirm you are in good health for the surgery. You may also need to stop taking certain medications such as blood thinners, and if you have diabetes you may also need to adjust your medication to avoid blood sugar levels from dropping to dangerous levels.

    During a coronary artery bypass grafting

    Coronary artery bypass grafting is performed under general anaesthesia.

    The surgeon will first need to remove the veins to be used to bypass the blockage. Next, to access the coronary artery, a cut will be made through the chest and chest bone.

    You will then be connected to a heart-lung machine (on-pump operation) or sections of your heart will be stabilised (off-pump operation).

    One end of the bypass graft will be sewn around a small opening just below the blockage in the artery, and the other end to a small opening in the aorta. Blood will flow around the blockage through this bypass graft.

    Next, a chest tube and temporary pacing wires will be inserted – the chest tube allows fluids to drain while the pacing wires will help to monitor for any abnormal heart rhythm.

    What to expect after a coronary artery bypass grafting

    As it will be several weeks before you can resume normal activity, it is best to make arrangements in advance for transport, housekeeping, and meals.

    Recovery period for a coronary artery bypass grafting

    You will remain in ICU for 1 or 2 days of observation. Most patients can leave the hospital in a week. However, it will take around 2 months to fully recover from the surgery.

    Risks/complications of a coronary artery bypass grafting

    The risk of complications from coronary artery bypass grafting generally depends on your overall health and may include irregular heart rhythm (arrhythmias), stroke, heart attack or kidney problems. It may also be possible to experience memory loss or have trouble thinking clearly, which often improve within 6 – 12 months.

  • At Mount Elizabeth Hospitals, our experienced team of cardiovascular specialists are ready to help you address any queries or concerns about coronary artery bypass grafting or coronary artery disease. Please contact us for an appointment.

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    • Agasthian T

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      Mount Elizabeth Medical Centre
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      Mount Elizabeth Novena Specialist Centre
      Singapore 329563
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      Clinic:
      Asian Heart & Vascular Centre Pte Ltd
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