PERCUTANEOUS CORONARY INTERVENTION (PCI)
CORONARY ARTERY BYPASS GRAFTING
Dr. Richard Mansfield
BSc (Hons) MB ChB MD FRCP FESC
CONSULTANT CARDIOLOGIST
Note: I am happy to answer general questions regarding the content of this website, but I cannot give clinical advice. Such requests will not be answered.
Coronary artery bypass grafting (CABG) is a routine treatment for patients with severe coronary artery disease. A number of grafts may need to be placed on the heart. Mostly this is carried out through a sternotomy, which is an incision through the breastbone. Traditionally the surgery was conducted with the heartbeat arrested and a pump taking over the circulation. Increasingly, however, patients have so called off pump surgery where the heart remains beating throughout the operation. Minimally invasive (key-hole) surgery is also carried out in certain situations.
Coronary Artery Bypass Surgery
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Coronary Artery Bypass Surgery - Coronary artery surgery usually requires the heart to be exposed by splitting the breastbone so the surgeon can operate.
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Grafts are made from the patients' own arteries or veins. Artery grafts include the internal mammary artery (IMA) or the radial artery in the forearm. Artery grafts have a life span of over 20 years and vein grafts an average of 10-12 years.
Overall the risks of bypass surgery are small and in the order of 1 or 2% (including death and stroke) however most patients have an excellent outcome. Patients are usually in for hospital for between 5 and 7 days.
Many patients after bypass surgery may return to work after about 6-8 weeks.
Yes.
Whilst CABG is a very effective treatment it must be combined with a number of medications in the long term to reduce the risks of the grafts furring up. These include aspirin, statins and often beta-blockers and ACE inhibitors.