Coronary Artery Bypass Grafting (CABG)

A surgical procedure for coronary artery disease

What Is Coronary Artery Bypass Grafting?

Coronary artery bypass grafting (CABG) is a surgical operation aimed at restoring blood flow in the coronary arteries of the heart in cases of coronary artery disease (CAD).
The essence of the procedure is to create a bypass (shunt) around a narrowed or completely blocked segment of an artery.

CABG helps prevent myocardial infarction and significantly improves the patient’s quality of life.

As a shunt, the surgeon uses either the internal thoracic artery or a vein or artery taken from the patient’s legs or arms.
This creates a new path for blood flow, bypassing the damaged area.

Preparation for Surgery

Before the operation, a comprehensive diagnostic evaluation is performed:

• Coronary angiography (mandatory to determine indications)
• Echocardiography (heart ultrasound)
• Ultrasound of the carotid arteries (BCA)
• CT scan of the chest and mediastinum
• Ultrasound of the lower limb vessels
• Consultations with a cardiologist, anesthesiologist, and cardiac surgeons

If the surgery is elective, preparation usually takes 1–3 days.
In cases of acute coronary syndrome, it is performed urgently.

How the Surgery Is Performed

1. The patient is under general anesthesia.
2. An incision is made along the midline of the chest (sternotomy).
3. In parallel, grafts (shunts) are harvested from the legs or arms.
4. The heart-lung machine is connected, and the heart is temporarily stopped using cardioplegia.
5. The surgeon places the shunts — new blood flow pathways that bypass the stenosed or occluded arteries.
6. After blood flow is restored and the incision is closed, the patient is transferred to the intensive care unit.

The operation typically lasts 3–4 hours, depending on the number of grafts and the patient’s condition.

Recovery After Surgery

• 1 day in intensive care, then transfer to the specialized cardiac ward
• Daily check-ups, dressings, ECG, blood pressure, and respiratory monitoring
• Gradual increase in activity — getting up, walking, breathing exercises
• Hospital stay — 7 to 10 days, longer if needed
• Upon discharge, the patient receives detailed recommendations on medication, lifestyle, and cardiology follow-up

It is very important to adhere to the recovery plan and take medications as prescribed to prevent recurrent complications.

Prognosis and Result

In most cases, the surgery eliminates angina symptoms, reduces the risk of heart attack, and prolongs life.
The effectiveness is especially high in patients with multi-vessel disease.

Advantages of CABG:

• Long-term effect (10–15 years or more)
• Improved myocardial blood supply
• Possibility to correct other conditions (e.g., aneurysm) during surgery

Disadvantages:

• Long recovery period
• Possible postoperative pain and limited physical activity for 1–2 months

Frequently Asked Questions

How much does the surgery cost?

The operation can be performed free of charge under the national health insurance program or federal quota.
Paid surgery is also available starting from 512,000 rubles, with personalized conditions.

When is CABG recommended instead of stenting?

When multiple arteries are affected, a complete blockage is present, or the patient has diabetes — CABG is usually preferred, especially for complex anatomy.

When can I return to work?

Full work activity is typically possible about 6 months after the sternum heals, depending on the type of work and recovery progress.