Heart and Vascular Health What Is Coronary Artery Bypass Graft (CABG) Surgery? By Heart and Vascular Institute, July 7, 2017 You probably know someone who has had heart bypass surgery, but what exactly does this mean? Coronary artery bypass graft surgery, or CABG surgery, is a frequent procedure that brings healthy blood flow back to the heart. According to the National Heart, Lung, and Blood Institute, CABG is the most common type of open-heart surgery in the United States. Learn more about the types of CABG procedures and what you can expect. For more information about CABG surgery, contact the UPMC Heart and Vascular Institute at 1-855-UPMC-HVI (876-2484). What Is Coronary Artery Disease? Your coronary arteries bring blood to your heart to help it pump. Coronary artery disease happens when plaque, which is made up of cholesterol, fatty deposits, calcium, and other substances builds up on your artery walls. Plaque can harden and narrow or completely block your arteries. It can also break apart, causing blood clots that block blood flow. Symptoms of coronary artery disease can include: Chest pain Pain or pressure in your shoulders, neck, arms, back, or jaw Shortness of breath In some cases, the first sign of coronary artery disease can be a heart attack, a serious medical emergency that may be life-threatening. If you think you or someone else is having a heart attack, call 911 right away. Early treatment could save your life. How Is Coronary Artery Disease Treated? Some people may be able to treat coronary artery disease with lifestyle changes, medicines, or procedures like angioplasty, which uses a catheter and balloon to open up a blocked artery. If these treatments don’t work for you, your doctor may recommend coronary artery bypass surgery. What Is Coronary Artery Bypass Graft Surgery? Coronary artery bypass graft (CABG) surgery creates a new route for blood to flow around a blocked artery. During a CABG procedure, a surgeon takes a healthy artery or vein from another part of your body — called a graft — and uses it to bypass the blocked artery so blood can flow properly. Depending on the number of blocked arteries you have, you may need more than one bypass. For example, if you’ve ever heard someone say they had triple bypass surgery, that means they had three bypasses created. What Happens During CABG Surgery? Before your surgery, you’ll be placed under anesthesia so you’re asleep during the procedure. A team of experts — including a surgeon, anesthesiologist, and nurses — will care for you throughout your surgery. During a traditional CABG procedure, your surgeon will make a large cut in your chest and breastbone to open your rib cage. You’ll receive medicine to stop your heart, but will be placed on a heart-lung bypass machine that will take over the work of your heart and lungs to move blood throughout your body. Your surgeon will take a graft from a healthy artery or vein, usually in your chest or leg, and sew it around the blocked artery to make a new route for blood to flow. Once the graft is in place, your doctor will restart your heart and take you off the heart-lung bypass machine. Your surgeon will close your breastbone with wire, and close your chest with stitches or staples. Depending on your condition and medical history, your surgeon may choose to perform: Off-pump coronary artery bypass graft surgery. This is similar to traditional CABG surgery, but your surgeon will not stop your heart. Instead, he or she will use a device to control your heartbeat during the procedure. Minimally invasive direct coronary artery bypass graft (MIDCAB) surgery. This is an alternative to traditional or off-pump bypass surgery that does not require your surgeon to open your chest or put you on a heart-lung machine. Your surgeon will make several small cuts to reach the blocked arteries, rather than opening your chest to get to your whole heart. What Happens After CABG Surgery? For most people, recovery after CABG surgery takes about 6 to 12 weeks. You’ll stay in the hospital for about one week after your surgery, depending on what type you had and your overall health. Once you’re able to go home, your doctor will give you information about how to care for your incisions, how you might feel in the days ahead, and when to seek medical help if you need it. Your doctor will also talk with you about when you can get back to your normal activities and will likely suggest a cardiac rehabilitation program to help you recover. CABG surgery is usually successful, but it is possible to develop blockages in other arteries. Your doctor will recommend medicines and lifestyle changes that can help you lower your risk for blocked arteries in the future.