CABG - coronary artery bypass grafting

CABG is a type of heart surgery used for treatment of coronary artery disease where blocked or narrowed coronary arteries are bypassed by other arteries and veins taken from other part of the body. 


The mainstay of coronary artery disease treatment is medication (aspirin, beta-blocker, ACE-I, statin), but in some cases, invasive procedure – revascularization – is necessary to restore sufficient blood supply to the heart and thus prevent angina and reduce the risk of a heart attack. Revascularization can be carried out as a catheter procedure (PCI, percutaneous coronary intervention, also called angioplasty, usually including stenting) or surgically as a CABG. Both options have their pros and cons, and Dr Ruzicka will be able to advise on the best strategy in your case.

The procedure

CABG is carried out as open-heart surgery by a cardiac surgeon under general anaesthesia. The narrowed segment of the diseased coronary artery is bypassed with an arterial or veinous graft taken from another part of the body. The artery used as a bypass is usually taken from the inner side of the left side of the chest wall (left internal mammary artery, LIMA), veins are taken from the legs (great saphenous vein, VSM). Depending on the extent of the coronary artery disease, the surgeon will attach one or more grafts, in most cases 2-4 grafts.


Recovery following CABG depends on many factors, including patient’s age, fitness, heart’s pumping function, associated diseases, such as diabetes and kidney function, the extent of the operation and presence or absence of complications. Most patients leave the hospital less than a week after the surgery and, after several weeks, can resume their job and all normal activities.


CABG is a time-proven procedure with a perioperative mortality rate of about 1-2% and the additional risk of complications including heart attack and stroke, which needs to be considered in the context of symptoms and risks if a prognostically beneficial operation is not carried out.

Most patients get significant and long-lasting relief from angina, and their risk of heart attack is reduced. However, CABG is a palliative procedure rather than a cure for coronary artery disease. The disease may progress, and native coronary arteries or grafts can get again narrowed and blocked with recurrence of angina, particularly if the operation is not followed by a change in lifestyle, improved control of risk factors and correct medication.

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