Coronary Artery Bypass Grafting in Saint Petersburg

Surgery Video

A video showing how coronary artery bypass grafting is performed — from preparation to results

About the Surgery

CABG is one of the most studied and effective techniques in cardiac surgery. The procedure is performed under general anesthesia in a specialized operating suite at Pirogov Clinic. During the period of cardiac arrest, all vital functions are maintained by the cardiopulmonary bypass machine.

3–4 hours
surgery duration

general
anesthesia

7–10 days
hospital stay

When Is CABG Indicated?

Multivessel coronary artery disease

Left main coronary artery stenosis

IHD combined with heart valve disease

Restenosis after previous stenting

Acute coronary syndrome with concurrent lesions

Anatomy unfavorable for stenting

CABG indications are determined jointly by a cardiologist and cardiac surgeon based on coronary angiography results and assessment of cardiac vessel condition. Our clinic applies an individualized approach to treatment planning.

How Is CABG Performed?

1

General Anesthesia

The patient is placed under deep medical sleep; the anesthesiologist and perfusionist are present throughout the entire procedure.

2

Sternotomy

The surgeon makes an incision along the midline of the sternum to access the heart. A second surgeon simultaneously harvests the graft — a vein or artery for the bypass.

3

Cardiopulmonary Bypass (CPB) Connection

A cardiopulmonary bypass machine temporarily takes over circulation and oxygenation, maintaining all vital organs while the heart is stopped.

4

Bypass Grafting

The surgeon routes the graft vessels around the narrowed or completely blocked segments of the coronary arteries. The number of grafts depends on the number of affected vessels.

5

Cardiac Activity Restoration

After the grafts are placed, the cardiopulmonary bypass machine is disconnected and the heart is confirmed to be beating independently.

6

Closure and Transfer to ICU

The chest is closed in layers. The patient is transferred to the intensive care unit for monitoring.

Surgery duration is 3–4 hours; with 4 or more grafts, CABG may take up to 5–6 hours.

What Does CABG Achieve?

Elimination of Angina

In the vast majority of cases, chest pain disappears completely and the patient returns to an active life without nitrates.

Long-term Effect: 10–15 Years

Grafts function for 10–15 years or more, freeing the patient from all IHD symptoms and daily limitations for decades.

Simultaneous Treatment of Related Conditions

When needed, additional cardiac pathologies can be addressed during the same surgery — valve replacement or left ventricular aneurysm resection.

CABG Cost in Saint Petersburg

Coronary Artery Bypass Grafting (1 graft)Includes all consumables and hospital stay: from 512,000 ₽
CABG (2 grafts, standard)Most common procedure volume: from 620,000 ₽
CABG with aneurysm resection: as indicated
Off-pump CABG (beating heart surgery): as indicated
Additional studies (echocardiography, coronarography): by prescription

CABG may be performed free of charge under CHI and federal quotas. Please consult a specialist.

Surgeons Performing CABG at Pirogov Clinic

Preparation for Surgery

Before elective CABG, our clinic conducts a comprehensive pre-operative assessment:

Coronarography — mandatory to assess coronary anatomy and plan the procedure

Echocardiography — evaluation of myocardial function and valve condition

Vascular ultrasound of lower limbs and carotid arteries

CT scan of the chest

Laboratory tests: CBC, biochemistry, blood type, coagulation panel

Consultations: cardiologist, anesthesiologist; pulmonologist or endocrinologist if needed

Anticoagulants must be stopped 5 days before surgery. Inform the cardiac surgeon of any allergies (latex, contrast, iodine, antibiotics). The clinic will provide a detailed preparation checklist.

Recovery After Surgery

In Hospital

1–2 days in ICU: ECG, blood pressure, breathing and urine output monitoring

Transfer to the cardiac ward on the second or third postoperative day

Breathing exercises and physiotherapy begin in the first days

Anticoagulant therapy — essential to prevent graft thrombosis

Discharge on day 7–11 with an uncomplicated postoperative course

After Discharge

Continue prescribed medications: statins, aspirin, beta-blockers

Follow-up visit — 4–6 weeks after discharge

Physical activity restriction: walking only at first, rehabilitation starts at 1–3 months

No driving for at least 2 months

Return to office work — 4–6 weeks; physical labor — up to 6 months

It is essential not to skip medications and regular cardiology check-ups. Following your doctor's recommendations significantly reduces the risk of repeat surgery.

Patient guideRecovery after heart surgeryThe first weeks at home, recovery time, warning signs and cardiology follow-up.

Related conditions and procedures

Frequently Asked Questions

What is coronary artery bypass grafting in simple terms?

CABG is a surgery in which the surgeon creates a detour for blood around a narrowed or blocked coronary artery. The patient's own vessel (vein or artery) is attached from the aorta to the coronary artery beyond the blockage. After surgery, blood flows freely to the heart muscle.

When is CABG chosen over stenting?

Stenting is preferred for 1–2 affected arteries without complex anatomy. CABG is indicated for multivessel disease, left main stenosis, diabetes, reduced left ventricular function, or anatomy unfavorable for stenting. The choice is always made jointly by a cardiologist and cardiac surgeon.

How long do patients live after CABG?

Grafts function for an average of 10–15 years or more. Most patients return to a full life without pain or serious limitations. Life expectancy depends on comorbidities, adherence to recommendations, and regular cardiology follow-up.

Is CABG painful? How is the surgery tolerated?

The operation is performed under general anesthesia — the patient feels nothing. After waking up, there may be moderate chest discomfort controlled by pain medication. Most patients find the first 2–3 days most challenging, after which they improve daily.

Can CABG be done for free in Saint Petersburg?

Yes. At Pirogov Clinic, CABG is available free of charge under CHI and federal quotas with the appropriate referral. To obtain a quota, consult your local cardiologist. Paid treatment eliminates waiting and allows surgery at a convenient time.

How long does CABG surgery take?

Typically 3 to 4 hours. With 4 or more grafts, or when additional procedures are performed simultaneously (valve replacement, aneurysm repair), the duration may extend to 5–6 hours.

What are the possible outcomes after CABG?

Most patients report a significant improvement in quality of life: chest pain disappears, exercise tolerance improves, and nitrate use is reduced or eliminated. Possible complications include wound infection, arrhythmias, and graft thrombosis — but their frequency is minimal at specialized centers.

How much does CABG cost in Saint Petersburg?

At Pirogov Clinic, CABG (1 graft) starts at 512,000 ₽. With 2 grafts — from 620,000 ₽. The exact cost depends on complexity and the number of grafts. Surgery is available free under CHI and federal quotas.

Can elderly patients undergo CABG?

Yes, age alone is not a contraindication. Patients over 70–80 may undergo CABG if their condition is compensated and there are no severe comorbidities. When surgical risk is high, less invasive options such as stenting or off-pump CABG may be preferred.

How to get care at the Center

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Coronary Artery Bypass Grafting (CABG)