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Coronary artery bypass graft (CABG)

One option to treat the blocked coronary artery is a surgical procedure called coronary artery bypass grafting surgery. The procedure involves taking a section of blood vessel from elsewhere in the body, such as the leg, and grafting it onto a location on the heart, which allows blood to bypass the blocked portion of the coronary artery. The procedure begins with the surgeon making a cut in the leg and removing a section of vein. Both ends of the vein are tied-off in the leg and cut is closed. The blood circulation in the leg is not compromised because the leg has many other veins, which can take over circulation in the area of the removed vein. The surgeon will then divide the sternum, the bone that runs down the middle of the chest, exposing the chest cavity. The heart is then usually connected to a heart-lung machine, which takes over the work of the heart and lungs during the treatment. Once this is complete, the heart is stopped. The surgeon then locates the blocked coronary artery and attaches the section of vein taken from the leg to the aorta and to the coronary artery below the blocked segment of the artery. The surgeon may do as many bypasses on as many blocked coronary arteries as the patient needs. Once each bypass graft is placed, it is checked for leaks. Following this, the heart is restarted. Once the heart is beating again, the surgeon will remove the leads to the heart-lung machine and sew the openings closed. Following this the chest is closed. The surgeon will leave pacemaker wires in the heart and bring them out to the skin to help control any heart rhythm problems the patient may have.

Coronary artery bypass graft (CABG)

Review Date: 11/2/2021

Reviewed By: Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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