Prior to Procedure
Your doctor will likely do the following:
Talk to your doctor about your medication. You may need to stop taking certain medication for one week before surgery, such as:
- Aspirin and other nonsteroidal anti-inflammatory drugs (eg, ibuprofen , naproxen )
- Blood-thinning drugs, such as warfarin (Coumadin)
- Anti-platelet drugs, such as clopidogrel (Plavix)
Your doctor may also ask you to:
- Eat a light meal the night before. Do not eat or drink anything after midnight.
- Arrange for a ride to and from the hospital.
- Arrange for help at home after the procedure.
Description of Procedure
A breathing tube will be placed in your throat. Next, an incision will be made through the skin. The breastbone will be split to open the chest. A heart-lung machine will be connected. Since the heart needs to be stopped for the surgery, this machine will act as the heart and lungs.
An artery will be taken from the chest wall. Or, a section of vein will be removed from the leg. This section will be used as the bypass. Once the heart is stopped, the new vessels will be connected (grafted) to the blocked arteries. One end will be attached just above the blockage. The other end will be attached just below the blockage. When the grafts are in place, the heart will be allowed to "wake up." Electrical shocks may be needed in some cases to regulate the heart’s rhythm. The heart-lung machine will be disconnected. Temporary tubes may be placed in your chest to help drain any fluid. The breastbone will be wired together. The chest will be closed with stitches or staples.
There is a less invasive approach, called minimally invasive coronary artery surgery. The purpose of this surgery is the same, but the technique and condition of the patient are different. Patients who have only one or two clogged arteries may be candidates for this approach. In this technique, a small incision is made in the chest. The doctor usually uses an artery from inside the chest for the bypass. The key difference in this technique is that the doctor performs the surgery while the heart is beating. With this technique, the heart-lung machine is not needed. If you need CABG, your doctor will carefully evaluate you to determine the best technique for you.