Coronary Artery Bypass Grafting (CABG)

Coronary artery bypass grafting (CABG) is a surgical procedure that restores normal blood flow in the coronary arteries by bypassing the narrowed (stenotic) segment of the vessel with grafts.

Coronary artery bypass grafting is a surgical method of correcting ischemic heart disease (IHD), aimed at increasing blood flow to the heart muscle (myocardium).

One of the most serious complications of IHD, characterized by high mortality, is myocardial infarction (MI). Every year, more than 15 million new cases of myocardial infarction are recorded worldwide, making the problem of high mortality among the working population particularly relevant. The «gold» standard for diagnosing IHD is coronary angiography, based on which the surgeon evaluates the degree of coronary artery narrowing and the possibility of surgical treatment.

Upon admission to the clinic, a full range of examinations is performed, including: echocardiography (heart ultrasound), ultrasound of the brachiocephalic (neck) vessels, computed tomography (CT) of the chest and mediastinum organs, and ultrasound of the lower limb vessels. You will be examined by your attending cardiologist, anesthesiologist, and a team of operating surgeons. Preparation for coronary artery bypass surgery usually takes 1 to 3 days (excluding emergency indications).

Summary of coronary artery bypass grafting (CABG). It is important to emphasize that coronary artery bypass grafting is microsurgery because the surgeon operates on arteries with a diameter of 1.0-3.5 mm.

The essence of the operation is to create a bypass for blood, bypassing the diseased (stenotic or occluded) segment of the coronary artery. There are two main methods of creating a bypass: mammary artery bypass grafting (using the internal mammary artery) and autovenous (using the patient's own vein) or autoarterial (using the patient's own artery) grafting. The incision providing access to the heart will be made along the midline of the sternum. The second incision or incisions are usually made on the legs (shin and thigh), and in some cases on the arms (forearm). It is there that surgeons will take a portion of the vein or artery to be used for grafting.

Throughout the heart bypass surgery, you will be under general anesthesia. While the cardiac surgeons perform their part of the work, the heart «rests» under the protection of artificial blood circulation apparatus and cardioplegic solution. After a successful operation, the patient is transferred to the intensive care unit, where continuous monitoring is provided using special equipment. The next day, if the patient's condition is stable, they are transferred to the cardiac surgery department for gradual recovery. Daily dressing changes are performed by surgeons for postoperative wounds. Patients usually stay in the clinic for 7-9 days, but the length of stay may vary depending primarily on strict adherence to all recommendations. You will notice an improvement in your overall condition and a surge of strength with each passing day.

Quite often, patients feel fear and confusion upon discharge, feeling safe under the care of experienced doctors at the clinic. You should remember that your attending physician will not discharge you until they are confident in stabilizing your condition and that further recovery should take place at home.