Koronarbypassoperation

Koronarbypassoperation, known in English as coronary artery bypass grafting (CABG), is a surgical procedure to restore blood flow to the heart muscle in patients with obstructive coronary artery disease. It involves creating new routes for blood to reach areas supplied by blocked coronary arteries by grafting vessels from elsewhere in the body or from a donor.

Indications include severe blockages in major coronary arteries, left main disease, or multivessel disease with symptoms like angina or evidence of limited blood flow despite medical therapy or prior interventions. It is often considered when percutaneous procedures are unlikely to provide durable relief or when extensive disease is present.

The operation typically involves opening the chest (median sternotomy) and using a heart-lung machine (cardiopulmonary bypass) to circulate blood while the heart is operated on. A graft, commonly the left internal mammary artery to the left anterior descending artery, is connected to bypass blocked segments. Other grafts use the saphenous vein from the leg or the radial artery. In some procedures the heart is operated on without the bypass machine (off-pump CABG).

Recovery usually requires several days in hospital and weeks to months of rehabilitation. Potential risks include bleeding, infection, stroke, heart attack, kidney failure, arrhythmias, and death, with risk depending on age, comorbidities, and extent of disease. Long-term benefits often include reduced angina, improved exercise tolerance, and longer survival in selected patients.

Alternatives include medical therapy and percutaneous coronary intervention (PCI) with angioplasty and stenting. The procedure was developed in the 1960s, with early successes by surgeons such as René Favaloro, and remains a common treatment for advanced coronary artery disease worldwide.