Center of Cardiovascular Surgery and Interventional Cardiology
at the N.I. Pirogov Clinic of High Medical Technologies of St. Petersburg State University
Center of Cardiovascular Surgery and Interventional Cardiology
at the N.I. Pirogov Clinic of High Medical Technologies of St. Petersburg State University
Cardiac Surgery · Saint Petersburg
Surgical restoration of blood flow in the coronary arteries for ischemic heart disease.
Free
under CHI and federal quotas
A video showing how coronary artery bypass grafting is performed — from preparation to results
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
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.
General Anesthesia
The patient is placed under deep medical sleep; the anesthesiologist and perfusionist are present throughout the entire procedure.
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.
Cardiopulmonary Bypass (CPB) Connection
A cardiopulmonary bypass machine temporarily takes over circulation and oxygenation, maintaining all vital organs while the heart is stopped.
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.
Cardiac Activity Restoration
After the grafts are placed, the cardiopulmonary bypass machine is disconnected and the heart is confirmed to be beating independently.
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.
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.
Coronary Artery Bypass Grafting (1 graft)
Includes all consumables and hospital stay
от 512 000 ₽
CABG (2 grafts, standard)
Most common procedure volume
от 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.
Dmitriy Shmatov
Professor, Deputy Director for Medical Affairs (Cardiac Surgery), Head of the Department of Cardiovascular Surgery, St. Petersburg State University Medical Institute
Стаж 25 лет
Maksim Kamenskih
Head of the Cardiac Surgery Department with an office for X-ray endovascular diagnostics and treatment
Стаж 21 лет
Gleb Kim
Cardiovascular Surgeon
Стаж 15 лет
Ruslan Kappushev
Cardiovascular Surgeon
Стаж 16 лет
Ilschat Asadullin
Cardiovascular Surgeon
Стаж 10 лет
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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