Coronary Artery Bypass Graft Surgery (CABG)

If you have been diagnosed with coronary artery disease and are experiencing symptoms such as chest pain or shortness of breath that limit your regular activities, heart bypass surgery may be an appropriate treatment option.

The goal of bypass surgery is to improve blood flow to the heart, which can relieve symptoms, enable you to resume a normal lifestyle, and lower the risk of a heart attack or other heart problems.

You’ll be glad to know that the cardiac surgeons at Northwest Regional Heart and Vascular have extensive experience in performing this type of surgery. In fact, the average hospital stay at Northwest Regional Heart and Vascular for coronary bypass surgery is 4.7 days compared with the national average of 6.8 days – an indication of our surgeons’ skill and expertise.

What is coronary artery disease?

Coronary artery disease (CAD) develops when a waxy substance called plaque builds up inside the arteries in the heart, narrowing the arteries (stenosis). Also called atherosclerosis, it reduces blood flow to the heart muscle, which can cause angina (chest pain), shortness of breath or even a heart attack.

How is coronary artery disease treated?

If one or more of your coronary arteries are blocked, treatment may include:

  • Lifestyle changes, including diet, exercise and stress management
  • Medication to control cholesterol and blood pressure
  • A minimally invasive catheter-based intervention called angioplasty (usually with the placement of a stent – a tiny metal scaffold – to prop open a narrowed artery
  • Bypass surgery

The most appropriate treatment approach depends on many factors including the severity of your coronary artery disease and its symptoms, the location of artery blockages, the presence of co-existing diseases and your overall health.

What does coronary artery bypass graft surgery involve?

In coronary artery bypass surgery, a healthy artery or vein is grafted to the coronary artery to divert blood around the blocked or narrowed portion. This creates a new route (a bypass) for blood and oxygen to reach your heart.

The healthy artery or veins are used from another part of the body, typically from inside the chest wall, or sometimes from inside the lower arm or the leg.

At Northwest Regional Heart and Vascular, coronary artery bypass graft (CABG) surgery is performed in one of the following ways:

  • Traditional coronary artery bypass surgery – This involves an incision of your breastbone to open the chest cavity. A heart-lung machine (also called a cardiopulmonary bypass machine) takes over the function of your heart and lungs during the surgery.
  • Off-pump or “beating heart” coronary artery bypass surgery – This also involves an incision of your breastbone to open the chest cavity, but the heart lung bypass is not utilized. Instead, special devices stabilize the part of the heart the surgeon is operating on.
  • Minimally invasive direct CABG (MIDCAB) – In this procedure, using robotic assistance, the surgeon makes a keyhole opening (small incision) on the left side of the chest, opening a small area between two ribs to access the blocked artery. While the heart is still beating, the surgeon grafts the blocked artery through the keyhole incision.
  • Hybrid procedure – This procedure combines a catheter-based approach (i.e., stent placement) performed by an interventional cardiologist and a MIDCAB procedure performed by a cardiac surgeon.

Because each patient is unique, your surgeon and medical team will work with you to decide which surgical approach is best for you and how long you will need to be in the hospital.

Am I a candidate for coronary artery bypass graft surgery?

You may be a candidate for coronary artery bypass graft (CABG) surgery if:

  • You have severe chest pain – even during light exercise or when you’re resting – that’s caused by narrowing of more than one of the arteries that supply blood to your heart muscle
  • More than one of your coronary arteries is narrowed or blocked, and your left ventricle – the main pumping chamber of the heart – doesn’t function well
  • Your left main coronary artery (the one that supplies most of the blood to the left ventricle) is severely narrowed or blocked
  • You have a blockage for which angioplasty is not appropriate, you’ve previously had angioplasty or stent placement that didn’t work, or you had a stent placed but the artery has narrowed again (a condition called restenosis)

Bypass surgery also may be performed in emergency situations, such as a heart attack.

What to expect after coronary artery bypass graft surgery

It’s important to understand that bypass surgery doesn’t cure the coronary artery disease that caused your blockages. That’s why lifestyle changes (diet, exercise and stress management) are an integral part of your treatment after surgery. It’s also routine to take medications that lower your cholesterol and reduce the risk of developing a blood clot.

We recommend starting cardiac rehabilitation four weeks after you leave the hospital. This medically supervised program includes exercise training, education on heart-healthy living, and counseling to reduce stress and help you return to an active life.

Would you like to learn more about coronary artery bypass graft surgery in Portland? Please call us to schedule a consultation: (503) 261-4430.