Coronary Artery Bypass Grafting (CABG), commonly known as heart bypass surgery, is a procedure that creates alternative pathways for blood to flow to the heart by bypassing blocked coronary arteries using grafts from the patient’s own arteries and veins. Traditionally, this surgery is performed on a still heart, with the heart-lung machine managing circulation during the operation. However, advancements in medical technology have led to a groundbreaking technique called Off-Pump Surgery. In Off-Pump CABG, the surgery is conducted while the heart remains beating, utilizing specialized equipment to maintain a controlled environment around the heart. This method aims to lower the risk of complications such as renal failure and stroke, as well as reduce the need for blood transfusions. The choice between on-pump and off-pump CABG is determined by the surgeon after a thorough assessment of the patient’s circulatory system, typically made during the surgery itself based on the individual’s medical condition.

Types of CABG

There are two primary types of grafts used in CABG: Arterial and Vein Grafts.

Arterial Grafts

Arterial grafts can be divided into two main types:

• Internal Thoracic Artery: This is a commonly used graft, also known as the internal mammary artery (IMA). There are two internal thoracic arteries in the chest that are preserved at their origin due to their supply of oxygen-rich blood. One end is cut and connected to the coronary artery below the blockage.
• Radial Artery: This is another frequently used arterial graft. Before utilizing a radial artery, various tests are conducted to ensure it’s the best option. After surgery, patients may be prescribed calcium channel blockers for several months to help keep the artery open. It’s common to experience numbness in the wrist following this procedure.

Vein Graft

The saphenous veins in the legs can be used as bypass grafts through a technique called minimally invasive saphenous vein removal. This method involves making one or two small incisions at the knee and a smaller incision at the groin, resulting in quicker recovery and less scarring compared to traditional surgical methods. However, these vein grafts tend to have a shorter lifespan compared to arterial grafts.