CABG (coronary artery bypass surgery) is a surgery performed to overcome significant obstruction in the coronary arteries supplying the heart. CABG is indicated when medical treatment is inadequate to control the angina pain.

CABG and stent placement are both used to overcome ischemic heart disease and the doctor determines which procedure is more suitable according to the patient condition.

CABG is the most common procedures performed in the cardiothoracic surgery with a high success rate reaching up to 98%. CABG has showed to have high efficiency in relieving angina, decrease the risk of MI and prolong survival.

CABG is performed in a specialized cardiac center. The surgery usually last between 4 – 6 hours, the number of the grafts will be determined by the surgeon. The surgeon takes a section of healthy blood vessel, often from inside the chest wall (left internal mammary artery) or from the lower leg (the great saphenous vein), and attaches the ends above and below the blocked artery so that blood flow is redirected around the narrowed part of the diseased artery.

After surgery, the patient will stay in the hospital according to his condition and his doctor’s decision for few days, which usually about 5-7 days (few days in the post-operative ICU and the rest is the ward).

The patient is expected to return to his daily activities and resume driving after 6 – 8 weeks after surgery.

CABG can be performed by different approaches:

• The traditional (on pump) CABG: it is done by an incision in the center of the chest and with the use of the heart-lung machine (cardiopulmonary bypass) which includes stoppage of the heart, performing the procedure and then allowing the heart to resume its activity. This technique is still the preferred and the most common technique used for CABG
• The Off pump (beating heart) surgery: it is also done by an incision in the center of the chest but without stopping the heart and without the use of the heart-lung machine. This type of surgery is challenging because the heart is still moving. It’s not an option for everyone.
• The minimally invasive approaches (Key-hole surgery): the surgeon performs CABG through small atypical incisions in the chest than the usual procedure to access a small area of the heart. This technique is suitable for certain patients and requires discussion with the surgeon.