Coronary Artery Bypass Graft Surgery (CABG) for the Treatment of Coronary Artery Disease (CAD)
The coronary arteries are blood vessels that carry blood and oxygen to the heart muscle. Coronary artery disease occurs when these arteries become clogged with fatty deposits (plaque). Plaque forms in the arteries over many years in a process called atherosclerosis. As plaque builds up, the artery opening gradually narrows and becomes clogged. Coronary artery disease is the single leading cause of death in the U.S.
The goal of CABG is to improve symptoms (quality of life) or to improve prognosis (how long you will live after the procedure) or both. Not everyone with coronary artery disease needs CABG surgery. In general, CABG is done when non-surgical treatment (such as lifestyle changes, medications) hasn't worked, when there are constant symptoms such as chest pain (angina) and/or the individual is not a good candidate for balloon angioplasty. CABG is also done when there are multiple coronary blockages that are life threatening. CABG does not cure coronary artery disease. Therefore, continued attention to risk factor modification (such as diet, weight loss, smoking cessation, exercise) is still needed.
Coronary artery bypass grafting (CABG) is an invasive surgical procedure. CABG is done to increase the blood supply to the muscle of the heart that has been decreased due to coronary artery disease. CABG is carried out under general anesthesia with the patient asleep. The chest is opened, the heart is temporarily stopped and blood is rerouted to a heart-lung (bypass) machine. The graft (blood vessel) is removed (harvested) from a vein in the lower leg, arm or an internal chest wall (mammary) artery. More than one graft can be done during the surgery. The graft is attached above and below the narrowed part of the coronary artery. Blood is redirected from the heart-lung machine back to the heart, which is restarted with controlled electrical shocks. The length of hospitalization is usually 5 to 6 days. Due to graft reblockage repeat surgery is sometimes necessary.Things to Consider
- This assessment will address coronary artery bypass graft surgery (CABG) using the heart-lung bypass machine only.
- Not everyone with coronary artery disease needs CABG surgery.
- You and your physician should discuss if CABG is the best treatment option for you.
See also:
Results
Will I live longer if I have non-surgical treatment for CAD?
Yes. Appropriate changes in lifestyle and use of medications can stop and possibly reverse the affects of CAD. However, for some people with certain types of CAD, non-surgical treatment may have to be combined with more aggressive treatments, such as balloon angioplasty and CABG.
Will non-surgical treatment of CAD improve my quality of life?
Yes. Successful non-surgical treatment can improve your physical ability to exercise and your mental and emotional sense of well being. However, the best treatment for CAD is prevention. Prevention can be accomplished through the six lifestyle changes previously mentioned - stop smoking cigarettes, lower high blood pressure, reduce high blood cholesterol, lose extra weight, become physically active, and manage diabetes.
Does non-surgical treatment of CAD make my symptoms better?
For many, the changes in lifestyle and medications used to treat CAD can control the symptoms and also slow or stop the progression of the disease.Safety
How safe is this for me?
Non-surgical treatment avoids the possible complications associated with the aggressive, invasive alternatives of balloon angioplasty and CABG. Non-surgical treatment may be tried, and if not adequate, can be supplemented with the more aggressive, invasive treatments.
Your health care provider will need to closely monitor lifestyle changes and medication usage associated with non-surgical treatment. If prescribed, medications must be taken as directed. Medications can have side effects. If side effects occur, they should be reported to the doctor. Often, a change in the dose or type of medication, or the use of a combination of medications, can stop the side effects.Comparison
Alternatives to CABG surgery may include:
- Non-surgical treatment (such as changes in lifestyle, medications)
- Surgical procedures that open blocked arteries (such as balloon angioplasty, coronary artery stenting)
Cost
CABG would be the most cost-effective treatment for an individual when it is the best treatment option.
The cost of a CABG procedure may range from $50,000 to $100,000.
The cost may or may not be covered by your health benefits plan.
Sources
The following are off-site links 
:
American Heart Association. (2008). Heart disease and stroke statistics. 2008 update at a glance. Retrieved January 20, 2009 from http://www.americanheart.org/downloadable/heart/1200078608862HS_Stats%202008.final.pdf.
MayoClinic.com. (2008, July). Coronary bypass surgery. Retrieved January 2, 2008 from http://www.mayoclinic.com/health/coronary-bypass-surgery/MY00087.
MedicineNet. (2007, May). Coronary artery bypass graft surgery (CABG). Retrieved January 2, 2008 from http://www.medicinenet.com/coronary_artery_bypass_graft/article.htm.
The Society of Thoracic Surgeons. (2008). Patient information. Coronary artery bypass grafting (CABG). Retrieved January 20, 2009 from http://www.sts.org/sections/patientinformation/adultcardiacsurgery/cabg/index.html?CFID=1153886&CFTOKEN=81704858.Next Review Date
1/21/2010
This document has been classified as public information.
Table of Findings
results: significant value
safety: moderate value
comparison: significant value
cost: significant value
total: significant value
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