Indications for Coronary Artery Bypass Graft (CABG)

Coronary artery bypass graft (CABG) is used to lower the risk of heart attack, or a second heart attack, caused by heart disease.

Helpful Highlights

  • Coronary artery disease (CAD), or heart disease, is the origin of most heart attacks.

  • Bypass surgery (CABG) is performed to prevent a heart attack, resolve an active heart attack, or foster better outcomes and quality of life after a heart attack.

  • Symptoms of CAD are like those of a heart attack, though often milder, with a couple of unique symptoms, as well.

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A cardiologist may recommend a coronary artery bypass graft (CABG) to lower the risk of a heart attack in the face of severe coronary artery disease (CAD) - in other words, before a heart attack ever happens. A CABG is also performed, of course, in an emergency to treat a severe heart attack that is a threat to life. CABG also may be used to treat people who have heart damage after a heart attack and still have blocked arteries.

Symptoms of coronary artery disease (CAD)

  • Chest pain (called angina)

  • Frequent or persistent fatigue, maybe weakness

  • Faster than normal heartbeat at rest (normal is 60-100 beats per minute) 

  • An irregular heartbeat (called arrhythmia)

  • Shortness of breath, usually with activity and not at rest

  • Swelling in the hands, feet/ankles, or even face

  • Frequent or persistent indigestion (heartburn, acid reflux)

  • Lightheadedness, maybe nausea

When CABG may be recommended

  • Other treatments, such as lifestyle changes (diet, exercise, habits) and/or medications haven't worked.

  • There are blockages in the heart that can't be treated with angioplasty (balloon or stent)

  • There are significant to severe blockages (> 70%) in one or more of the three large coronary arteries* that supply a major part of the heart muscle with blood, especially if the heart's pumping action is already weakened

*Left anterior descending artery and circumflex artery (that make up the left main coronary artery), and the right main coronary artery

Candidacy for CABG is based on several factors

  • The presence and severity of CAD symptoms

  • The severity and location of blockages in the coronary arteries

  • History and past treatment of heart disease, including surgeries, procedures, and medications

  • Response to other treatments

  • History of other medical problems, diseases, and conditions (called comorbidities)

  • Current quality of life

  • Age and general health and well-being

  • Family history of heart disease, heart attack, or other heart conditions

The goals of CABG

  • Improve survival odds

  • Improve the quality of life and decrease angina and other symptoms of CAD

  • Resume a more active lifestyle

  • Improve the pumping action of the heart

  • Lower the chances of an initial heart attack or second heart attack

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