CABG and Coronary Artery Bypass Grafting in Oxford

This page explains coronary artery bypass grafting, commonly called CABG or heart bypass surgery, for patients with coronary artery disease requiring cardiac surgery.

What is CABG (coronary artery bypass grafting)?

Coronary artery bypass grafting or CABG (loosely called ‘cabbage’ or bypass surgery) is a heart operation to treat problems with blood supply to the heart muscle, a condition called ‘coronary artery disease’.

What happens in coronary artery disease?

The heart muscle requires a continuous supply of ‘pure’ blood to function well. This is carried to the heart muscle by two arteries which give off branches making it effectively three main arteries. These give off further branches in turn to cover all areas of the heart. For various reasons (risk factors), in some people, over a period of time, fatty material builds within the fine arteries and this causes narrowing or obstruction within the arteries. This leads to reduced blood flow and can cause symptoms like chest pain (angina) or breathlessness or dangerous conditions like heart attacks and related complications.

How does CABG work?

The aim of the CABG operation is to restore blood supply to areas of the heart lacking adequate blood supply due to narrowings or obstructions in the coronary arteries. For this, new pathways of blood supply are created so fresh blood can reach downstream, beyond the narrowing or block, and hence the name ‘bypass operation’.

When is CABG a good option?

There are other options for improving the blood supply to heart muscle. Medications can help improve the blood supply but may not be sufficient especially if the disease is severe. Stenting (angioplasty) is another option, where cardiologists place a stent (a frame-like device) to squeeze the fatty material to the sides and improve the opening in the arteries.

CABG is recommended when there is extensive involvement of the heart arteries especially when patients are diabetic as well. In this situation, stents are either not possible or do not address all areas completely and the long-term results of multiple stents are known to be worse compared to CABG.

Ultimately the best option for a patient depends on the angiogram findings and a patient’s characteristics and it is best to discuss with a properly qualified expert doctor who has experience of dealing with this condition.

How is a CABG performed?

The operation is performed usually with a cut through the middle of the sternum (breastbone) to reach the heart. Additional cuts may be required on the legs for taking a vein or a forearm for taking an artery which are all used to provide substitute channels of blood flow. An artery inside the chest wall, the mammary artery, is almost always used at a bypass operation. One end of the artery or vein is attached to the coronary artery beyond the obstruction and the other end is connected usually to the aorta (the large artery supplying ‘pure’ blood to the body). The operation may be performed on a still heart with a heart-lung bypass machine supporting the circulation, or on a beating heart without the use of a heart-lung bypass machine. The two methods are largely equivalent although there are certain situations when one may be better than the other. However for all practical purposes, there is no difference between the two procedures. Your surgeon will be able to discuss further details with you as required. After the operation is complete, the chest is closed, usually with steel wires to hold the sternum together.

CABG and Heart Bypass Surgery FAQ

Who performs CABG in Oxford and surrounding areas?

Mr Vivek Srivastava is a consultant cardiac surgeon who performs coronary artery bypass grafting or heart bypass surgery as well as other adult cardiac surgery procedures.

Why might CABG be recommended instead of stents?

CABG may be recommended when coronary artery disease is extensive, involves multiple vessels, or when long-term outcomes are expected to be better with surgical bypass compared to stents.

Is CABG the same as heart bypass surgery?

Yes. CABG (or cabbage) stands for coronary artery bypass grafting and is commonly called heart bypass surgery or coronary bypass surgery.

When to See a Cardiac Surgeon About Coronary Artery Disease?

A cardiologist may refer you to a cardiac surgeon if coronary artery disease is extensive, involves several arteries, affects the left main coronary artery, or there are technical concerns with stents. Patients are often referred after an angiogram shows narrowed or blocked heart arteries.

A surgical consultation can explain whether CABG, stents, medication or a combined approach is most suitable for your circumstances.

What Symptoms Does Coronary Artery Disease Cause?

Coronary artery disease can cause angina, chest tightness, breathlessness, tiredness, reduced exercise tolerance or complications such as a heart attack and heart failure. Some patients especially ones with diabetes can have silent coronary disease i.e. without symptoms and are referred because scans or angiography show significant narrowing.

What to Expect Before CABG?

Assessment for CABG usually includes review of a patient's symptoms and general health, the angiogram and other tests of heart function, other medical conditions and the expected benefit of bypass grafts. The surgeon will discuss the operation, use of arteries or veins as grafts, risks, recovery and any alternatives.

How Is Recovery After CABG?

Recovery after coronary artery bypass grafting includes gradual return to full activity, wound healing, medication review and cardiac rehabilitation. Long-term treatment usually includes attention to cholesterol levels, blood pressure, diabetes and weight control. Lifestyle changes including adequate exercise and stopping smoking where relevant are also important.

CABG in Oxford and Nearby Areas

Mr Vivek Srivastava sees patients for CABG and heart bypass surgery advice in Oxford and London. He receives referrals from Oxfordshire (Oxford, Banbury, Abingdon, Didcot, Bicester, Witney) and surrounding areas including London, Northamptonshire (Northampton, Daventry, Kettering), Wiltshire (Swindon, Salisbury), Buckinghamshire (Milton Keynes, Aylesbury, High Wycombe), Warwickshire (Warwick), Berkshire (Reading) and Jersey.

Procedures