Coronary Artery Bypass Grafting (CABG)

This procuredure, performed under general anaesthesia, uses either a vein or artery conduit (pipe) to bypass a proximal stenosis (narrowing) or partial blockage in a coronary artery [[Figure 1](https://firebasestorage.googleapis.com/v0/b/health-shared.appspot.com/o/procedures%2FwZ618piep5SiJviq0mRxbhZ9dHx2%2Ffiles%2FCoronary%20Artery%20Bypass%20Graft.jpg?alt=media&token=f24e6c14-fe11-4864-82bf-5e9004c773b1) (18)]. The bypass either uses the internal mammary artery or a conduit attached to the aorta to bypass blood to the distal coronary arteries.The procedure is done via a midline sternotomy (cut through the breast bone). The heart is either stopped and the function of the heart and lungs is undertaken by a cardiopulmonary bypass machine or the procedure can be done 'off pump' on a beating heart.The breast bone is closed with sternal wires. In straight forward cases patients can be weaned off the ventilator early and allowed to wake up, other cases may require a longer period of ventilation and blood pressure support.CABG is generally performed in patients with limiting angina and:1) left main stem coronary stenosis of greater than 50%2) triple vessel disease3) two vessel disease including significant proximal left anterior descending (LAD) disease.CABG can also be considered in patients with heart failure and reversible ischaemia or in conjunction with valvular heart surgery.