Surgery can be done to restore and/or improve blood flow to the heart muscle, which helps the heart perform better. When heart attacks are severe, surgery may be done right away.
Coronary artery bypass grafting (CABG) is more commonly known as bypass surgery. It is the most common type of heart surgery in the United States. During this operation, a healthy blood vessel is removed from the leg or another area of the body. The healthy blood vessel is connected to a coronary artery just above and just below the blocked or partially blocked area. The attached blood vessel creates a new pathway so that the blood can move around the blocked artery. If more than one area is blocked, a bypass can be done for each area. Multiple bypasses are referred to as a double, triple, or quadruple bypass. There are variations of this procedure.
On-Pump or Off-Pump CABG
CABG is considered open-heart surgery. On-pump surgery is done while the heart is stopped. A heart-lung machine is used to circulate blood and oxygen throughout the body while the surgeon works on the heart. The heart is restarted when the surgeon is done.
No heart-lung machine is used during off-pump CABG. The surgeon works on the heart while it is still beating. This technique is more specialized, but several studies indicate that on- and off-pump CABG have similar short- and long-term results.
Minimally Invasive Direct CABG
Another option may allow you to have a less invasive heart surgery. During this procedure, small incisions are made along the left side of the chest and between the ribs to access front-facing blood vessels. It is a fairly new off-pump procedure that may not be an option for everyone or as widely available.
Talk to your doctor about which option is better for you.
Coronary angioplasty may also be referred to as a percutaneous coronary intervention (PCI). During this procedure, a catheter is inserted into an artery in your groin and passed through the blood vessels until it reaches the heart and the problem artery. Imaging is done throughout the procedure to monitor blood flow and the location of the catheter.
Variations of angioplasty include:
Although these procedures may relieve symptoms, it does not cure heart disease. You still must maintain a healthy lifestyle that includes achieving a healthy weight, eating a heart healthy diet, not smoking, and taking medications.
Heart attacks can cause permanent heart damage. Damage can affect the structure and function of the heart. Surgery can improve your quality of life by restoring blood flow around damaged tissue or regulating heart rhythms. Procedures include:
Acute coronary syndromes. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116779/Acute-coronary-syndromes. Updated February 22, 2017. Accessed March 2, 2017.
Cardiac procedures and surgeries. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartAttack/PreventionTreatmentofHeartAttack/Cardiac-Procedures-and-Surgeries_UCM_303939_Article.jsp#.VxE_0U2FMdU. Updated September 16, 2016. Accessed March 2, 2017.
Intra-aortic balloon pump. Texas Heart Institute website. Available at: http://www.texasheart.org/Research/Devices/iabp.cfm. Accessed March 2, 2017.
ST-elevation myocardial infarction (STEMI). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115392/ST-elevation-myocardial-infarction-STEMI. Updated January 30, 2017. Accessed March 2, 2017.
Shekar PS. Cardiology patient page. On-pump and off-pump coronary artery bypass grafting. Circulation. 2006;113(4):e51-e52.
What is coronary artery bypass grafting? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/cabg. Updated February 23, 2012. Accessed March 2, 2017.
Last reviewed March 2017 by Michael J. Fucci, DO, FACC
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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