Coronary Artery Disease

How Is CABG Surgery Performed? - Cardiac Bypass Surgery in India

Cardiac bypass surgery, also known as CABG, is a common treatment for blocked coronary arteries. This short explains the main steps of the procedure, from preparing the patient to closing the incision.

Anaesthesia and incision

The operation is performed under general anaesthesia, so you will be asleep throughout.

• Accessing the heart. The surgeon makes an incision down the centre of the chest and separates the breastbone to get a clear view of the heart.
• Using a heart-lung machine. In traditional CABG, your heart is temporarily stopped. A heart-lung machine takes over, circulating and oxygenating your blood during the surgery.
• Off-pump surgery. In some cases, the surgery can be performed on a beating heart. This is known as 'off-pump' bypass surgery and avoids the need for a heart-lung machine.

Creating the new pathway

The surgeon uses a healthy blood vessel, called a graft, from another part of your body to go around the blocked artery.

• Harvesting the graft. This vessel is usually taken from your leg (saphenous vein), arm (radial artery), or the inside of your chest wall (internal mammary artery).
• Attaching the graft. The surgeon sews one end of the graft onto the aorta and the other end onto the coronary artery, past the point of the blockage.
• Restoring blood flow. This creates a new channel for oxygen-rich blood to reach the heart muscle, bypassing the narrowed section.
• Multiple bypasses. If you have several blocked arteries, the surgeon may need to create several bypass grafts during the same operation.

Completing the surgery

• Checking the grafts. The surgeon checks that the new grafts are working well and that there is no bleeding.
• Restarting the heart. If a heart-lung machine was used, it is disconnected and your heart is restarted. It then begins to pump blood on its own again.
• Closing the incision. The surgeon closes the breastbone with wires and stitches the skin incision. You are then moved to an intensive care unit for close monitoring.

The specific details of a cardiac bypass operation, including the type of graft used and whether a heart-lung machine is needed, are decided on a case-by-case basis. A cardiac surgeon can determine your suitability for the procedure after a full evaluation of your medical history, reports, and recent imaging.