Get answers to your heart-related questions from UM Heart Center experts.
Off-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery - heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery
Heart bypass surgery creates a new route, called a bypass, for blood and oxygen to reach your heart.
Before your surgery you will get general anesthesia. You will be asleep (unconscious) and pain-free during surgery.
Once you are unconscious, the heart surgeon will make a 8-10-inch surgical cut (incision) in the middle of your chest. Your breastbone will be separated to create an opening. This allows your surgeon to see your heart and aorta, the main blood vessel leading from the heart to the rest of your body.
Most people who have coronary bypass surgery are connected to a heart-lung bypass machine, or bypass pump.
A newer type of bypass surgery does not use the heart-lung bypass machine. The bypass is made while your heart is still beating. This is called off-pump coronary artery bypass, or OPCAB. This procedure may be used if you could have problems while on the heart-lung machine.
During bypass surgery, the doctor takes a vein or artery from another part of your body and uses it to make a detour (or graft) around the blocked area in your artery.
After the graft has been created, your breastbone will be closed with wire. This wire stays inside you. The surgical cut will be closed with stitches.
This surgery can take 4 to 6 hours. After the surgery, you will be taken to the intensive care unit.
Your doctor may recommend this procedure if you have a blockage in one or more of your coronary arteries. Coronary arteries are the small blood vessels that supply your heart with oxygen and nutrients that are carried in your blood.
When one or more of the coronary arteries becomes partly or totally blocked, your heart does not get enough blood. This is called ischemic heart disease, or coronary artery disease (CAD). It can cause chest pain (angina).
Coronary artery bypass surgery can be used to treat coronary artery disease. Your doctor may have first tried to treat you with medicines. You may have also tried cardiac rehabilitation or angioplasty with stenting.
Coronary artery disease is different from person to person. The way it is diagnosed and treated will also vary. Heart bypass surgery is just one treatment. It is not right for everyone.
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Morrow DA, Boden WE. Stable ischemic heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 57.
Hannan EL, Wu C, Walford G, Culliford AT, Gold JP, Smith CR, et al. Drug-eluting stents vs. coronary-artery bypass grafting in multivessel coronary disease. N Engl J Med. 2008;358:331-341.
MÃ¸ller CH, Perko MJ, Lund JT, Andersen LW, Kelbaek H, Madsen JK, Winkel P, Gluud C, SteinbrÃ¼chel DA. No major differences in 30-day outcomes in high-risk patients randomized to off-pump versus on-pump coronary bypass surgery: the best bypass surgery trial. Circulation. 2010 Feb 2;121(4):498-504.
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