CABG + CPB

Coronary Artery Bypass Grafts (CABG) & Cardio-pulmonary Bypass (CPB)

In coronary heart disease, the arteries become blocked with atheroma. This decreases the blood flow to the heart, and angina or a heart attack may ensue. Coronary artery bypass grafts or CABG is a procedure carried out to improve blood flow to the heart by using healthy blood vessels transferring and grafting them to the hearts blood supply system.

The left side of the heart is responsible for pumping blood, oxygen and nutrients around the body. Consequently, it uses a lot of oxygen as fuel in this process. If an artery blocks on the left side, it is a serious problem, as the pumping mechanism will not be as effective as it should be. For the majority of patients undergoing grafting, an artery is used from another part of the body, commonly the saphenous vein in the legs or the left internal mammary artery.

This is found underneath the chest wall. This graft is generally placed in one of the arteries called the left anterior descending artery. This artery is extremely important for the left ventricle; using the internal mammary artery at this point confers a greater chance of the graft remaining patent.

This procedure is carried out under general anaesthetic. The surgeon makes an incision down the middle of the chest (sternotomy) in order to gain access to the heart and lungs. In order for the grafts to be adequately attached to the arteries, the heart is stopped (a process called cardioplegia) and the body’s blood and circulation is transferred to a cardio-pulmonary bypass machine. This specialised equipment takes over the role of the heart whilst the surgeon attaches the grafts. At the end of the operation, the heart is restarted again.

The procedure can take anything from 3-6 hours, depending on the severity of heart disease and the number of grafts required. Patients are routinely transferred to the intensive care unit to recover following this procedure.