Medical knowledge, Patient Education
Coronary Artery Bypass Grafting
Coronary Artery Bypass Grafting
Coronary artery bypass grafting (CABG) is a surgery to bypassor to fix arteries of the heart (coronary arteries) that are narrow or blocked. This narrowing is usually the result of a build-up of fatty deposits (plaques) in the walls of the blood vessels. The coronary arteries supply the heart with the oxygen and nutrients that it needs to pump blood through your body.
In this surgery, a section of blood vessel from another part of the body (usually the chest, arm, or leg) is removed and then placed where it will allow blood to flow around the damaged part of the coronary artery. The new section of blood vessel is called the graft.
Tell a healthcare provider about:
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Any allergies you have.
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All medicines you are taking or using, including steroids, blood thinners, vitamins, herbal medicines, eye drops, creams, and over-the-counter medicines.
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Any problems you or family members have had with anaesthetics.
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Any bleeding problems you have.
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Any surgeries you have had.
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Any medical conditions you have.
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Whether you are pregnant or may be pregnant.
What are the risks?
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Bleeding, which may require transfusions.
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Infection.
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Allergic reactions to medicines or dyes.
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Pain at the surgical site.
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Damage to other structures or organs.
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Short-term memory loss, confusion, and personality changes.
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Heart rhythm problems (arrhythmias).
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Stroke.
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Heart attack during or after surgery.
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Kidney failure.
What happens before the procedure?
Staying hydrated
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Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice and tea and coffee without milk or cream.
Eating and drinking
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8 hours before the procedure – stop eating heavy meals or foods, such as meat, fried foods, or fatty foods.
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6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
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6 hours before the procedure – stop drinking milk or drinks that contain milk.
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2 hours before the procedure – stop drinking clear liquids.
Medicines
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Take over-the-counter and prescription medicines only as instructed by your healthcare provider.
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Ask your healthcare provider about:
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Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners. You may be asked to start new medicines and stop taking others. Do not stop medicines or adjust dosages on your own.
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Taking medicines such as aspirin and NSAIDs. These medicines can thin your blood. Do not take these medicines unless your healthcare provider tells you to take them.
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Taking over-the-counter medicines, vitamins, herbal medicines and supplements.
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General instructions
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Ask your healthcare provider:
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How your surgical site will be marked or identified.
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What steps will be taken to help prevent infection. These may include:
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Removing hair at the surgical site.
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Washing skin with an antibacterial soap.
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Taking antibiotics.
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You may be asked to shower with an antibacterial soap.
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For 3–6 weeks before the procedure, do not use any products that contain nicotine or tobacco . These products include cigarettes, chewing tobacco and vaping devices, such as e-cigarettes. Quitting smoking is one of the best things you can do for your heart health. If you need help quitting, ask your healthcare provider.
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Talk with your healthcare provider about where the grafts will be taken from for your surgery.
What happens during the procedure?
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An IV tube will be inserted into one of your veins.
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You will be given one or more of the following:
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A medicine to help you relax (sedative).
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A medicine to make you fall asleep (general anaesthetic).
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An incision will be made down the front of the chest through the breastbone (sternum). The sternum will be opened so the surgeon can see the heart.
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You may or may not be placed on a heart-lung bypass machine. If this machine is used, your heart will be temporarily stopped. The machine will provide oxygen to your blood while the surgeon works on your heart. If the machine is not used, it is called beating heart bypass surgery.
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A section of blood vessel will be removed from another part of your body (usually the chest, arm, or leg).
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The blood vessel will be attached above and below the blocked artery of your heart. This may be done on more than one artery of the heart.
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When the bypass is done, you will be taken off the heart-lung machine if it was used.
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If your heart was stopped, it will be restarted and will take over again normally.
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Your chest will be closed with special surgical wire to hold your bones together for healing.
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Your incision(s) will be closed with stitches (sutures), skin glue, or adhesive strips.
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Bandages (dressings) will be placed over the incision(s).
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Tubes will remain in your chest and will be connected to a suction device to help drain fluid and re-inflate the lungs.
The procedure may vary among healthcare providers and hospitals.
What happens after the procedure?
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Your blood pressure, heart rate, breathing rate and blood oxygen level will be monitored until you leave the hospital.
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You may wake up with a tube in your throat to help your breathing. You may be connected to a breathing machine. You will not be able to talk while the tube is in place. The tube will be taken out as soon as it is safe.
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You will be groggy and may have some pain. You will be given painkillers to help control the pain.
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You may be in the intensive care unit for 1–2 days.
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You may be given oxygen to help you breathe.
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You will be shown how to do deep breathing exercises.
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You may have to wear compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs.
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You may be given new medicines to take after your surgery.
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Cardiac rehabilitation will be started while you are in the hospital. This may include education and exercises to help you recover from your surgery.
Summary
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In this procedure, a section of blood vessel from another part of the body (usually the chest, arm, or leg) is removed and then placed where it will allow blood to bypass the narrowed or blocked part of the coronary artery.
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For 3–6 weeks before the procedure do not use any products that contain nicotine or tobacco . These products include cigarettes, chewing tobacco and vaping devices, such as e-cigarettes. Quitting smoking is one of the best things you can do for your heart health. If you need help quitting, ask your healthcare provider.
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You may or may not be placed on a heart-lung bypass machine during the surgery. If used, this machine will provide oxygen to your blood while the surgeon works on your heart.
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You may wake up with a tube in your throat to help your breathing. You may be connected to a breathing machine. The tube will be taken out as soon as it is safe.
This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.
