Coronary Artery Disease

Surgery

The goals of surgery for coronary artery disease are to:

• Improve blood flow to the heart.
• Relieve chest pain (angina).
• Improve your chances of living a longer life.

Many people with heart disease can be treated by lifestyle changes and medicine or angioplasty. But sometimes coronary artery bypass graft surgery (CABG or "cabbage") is needed. It uses healthy blood vessels to create detours around narrowed or blocked arteries. Most of the time, bypass surgery is an open-chest procedure.

To learn more about angioplasty, see the Angioplasty and Other Treatment section of this topic.

Surgery Choices

Coronary artery bypass graft surgery improves blood flow to the heart. During this surgery, a doctor connects (grafts) a healthy artery or vein from another part of your body to the blocked coronary artery. The grafted artery goes around (bypasses) the blocked part of the artery. The bypass provides a new pathway for blood to your heart.

See a slideshow of how bypass surgery is done .

Sometimes transmyocardial laser revascularization (TMR) is used along with bypass surgery. This surgery uses a laser beam to improve blood flow to the heart. It is not common but may be done to reach areas of the heart where bypass grafting does not work as well.

What to Think About

Most of the time, people with severe heart disease benefit more from bypass surgery than from angioplasty.¹² Your treatment will depend in part on:

• How many arteries are blocked.
• How badly the arteries are blocked, and where.
• Other heart problems you may have.
• Your feelings about treatment.

It’s important to understand the benefits and risks of angioplasty versus bypass surgery. You can also read about other factors that affect treatment choices.

Surgery isn't right for everyone. Making lifestyle changes and taking medicine or having angioplasty can work just as well for some people. And these carry fewer risks than surgery.

No matter what treatment you receive, you'll still need to make changes in the way you eat and how much you exercise. These changes, along with not smoking, will give you the best chance of living a longer, healthier life.

To learn more, see:

Should I have coronary artery bypass surgery?

Should I have angioplasty for stable angina?

If you're thinking about surgery, ask your doctor how many heart surgeries your surgeon and the hospital perform each year. Find out how that number compares with heart surgeries done at other hospitals. People who have bypass surgery at hospitals that do many heart surgeries tend to have better results.

Cardiac rehabilitation

After your surgery, your doctor may suggest that you attend a cardiac rehabilitation program. In cardiac rehab, a team of health professionals provides education and support to help you recover.

The rehab team can help you make new, healthy habits, such as eating right and getting more exercise. Making these changes is just as important as getting treatment in keeping your heart healthy and your arteries open.

For more information, see the topic Cardiac Rehabilitation.

More Information: How do I prepare for CABG surgery? How will I recover from CABG surgery? What can I do to help my recovery from CABG surgery?

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Author:	Robin Parks, MS	Last Updated: May 29, 2008
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Robert A. Kloner, MD, PhD - Cardiology Ruth Schneider, MPH, RD - Diet and Nutrition
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