Coronary Artery Bypass Surgery

Coronary artery bypass grafting (CABG) is a surgery that creates new pathways around blocked heart arteries using blood vessels taken from elsewhere in the body — usually the chest wall, arm, or leg. CABG is commonly done for severe coronary artery disease that isn't suitable for stenting, or for disease affecting multiple vessels. CABG is widely performed across India, including through government schemes.

When is CABG recommended?

• Significant narrowing of the main left coronary artery
• Multiple-vessel disease, particularly with reduced heart function
• Symptoms not controlled by medicines and not suitable for stenting
• Failed previous angioplasty or recurring blockages
• Some heart attack patients — when other treatments are not ideal
• Combined with other heart surgery (valve replacement, etc.)

What's involved

• General anaesthesia; surgery typically lasts 3-6 hours
• Traditional (on-pump) CABG — the heart is stopped briefly; a heart-lung machine takes over blood circulation
• Off-pump / beating-heart CABG — surgery on a beating heart without the bypass machine; widely used in India
• Minimally invasive CABG — smaller incisions, less invasive in selected patients
• Typically 1-4 grafts are placed, depending on disease
• Hospital stay 5-7 days; longer if complications
• Cardiac ICU for the first 1-2 days

Risks

• Overall, CABG has a low mortality rate in good-volume centres
• Risks include bleeding, infection, stroke, heart rhythm problems, kidney injury, lung complications
• Older age, diabetes, kidney disease, and other heart conditions raise risk
• Long-term graft patency — vein grafts can narrow over years; arterial grafts (internal mammary) tend to last longer

Recovery

• 6-12 weeks to feel fully recovered; longer for people with complicated surgery
• Pain is well-controlled with modern analgesia
• Cardiac rehabilitation — supervised exercise, risk-factor education, psychological support — meaningfully improves outcomes. Strongly recommended after CABG.
• Driving — usually restricted for 4-6 weeks
• Gradual return to work, in consultation with your doctor
• Follow-up cardiology appointments

After surgery — long-term

• Strict risk-factor control — blood pressure, cholesterol, diabetes
• Stop smoking — fundamental
• Medicines — antiplatelets, statins, others as prescribed. Take them consistently.
• Heart-healthy diet, regular exercise, stress management
• CABG treats existing blockages but doesn't cure the underlying disease — without lifestyle change, new blockages can develop