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'''For the WikiPatient page for this topic, click [[{{PAGENAME}} (patient information)|here]]'''
'''For the WikiPatient page for this topic, click [[{{PAGENAME}} (patient information)|here]]'''
{{Coronary artery bypass surgery}}
{{Coronary artery bypass surgery}}
{{CMG}}; '''Associate Editors-In-Chief:''' [[User: Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@perfuse.org]; {{CZ}}; {{VK}}
{{CMG}}; '''Associate Editors-In-Chief:''' [[User: Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@wikidoc.org]; {{Anahita}}; {{CZ}}; {{VK}} {{PTD}}
   
   
'''''Synonyms and keywords:''''' Coronary artery bypass grafting, and colloquially heart bypass, bypass, bypass surgery, open heart surgery, or CABG (pronounced like cabbage), aortocoronary bypass (ACB). The term Coronary Artery Graft Surgery (CAGS) is often used outside the United States and should not be confused with [[Coronary angiography|Coronary Angiography (CAG)]]. OPCAB refers to [[Off-pump coronary artery bypass]], a procedure during which the patient is not placed on extracorporeal circulation ("the pump").
'''''Synonyms and keywords:''''' Coronary artery bypass grafting, and colloquially heart bypass, bypass, bypass surgery, open heart surgery, or CABG (pronounced like cabbage), aortocoronary bypass (ACB). The term Coronary Artery Graft Surgery (CAGS) is often used outside the United States and should not be confused with [[Coronary angiography|Coronary Angiography (CAG)]]. OPCAB refers to [[Off-pump coronary artery bypass]], a procedure during which the patient is not placed on extracorporeal circulation ("the pump").


==[[Coronary artery bypass surgery overview|Overview]]==
==[[Coronary artery bypass surgery overview|Overview]]==
[[Coronary artery bypass surgery]] ([[Coronary artery bypass surgery|CABG]]) is a [[surgery|surgical]] [[coronary revascularization|revascularization]] procedure that is used to circumvent or bypass blockages in the [[Epicardium|epicardial]] [[coronary arteries]] associated with [[acute coronary syndromes]] (including [[ST elevation MI]], [[non ST elevation MI]], [[unstable angina]]) and [[stable angina]]. The technique was pioneered by Argentine [[cardiac surgeon]] [[René Favaloro]] at the [[Cleveland Clinic]] in the late 1960s. As part of the procedure, [[artery|arteries]] or [[vein]]s from elsewhere in the [[patient]]'s body are [[medical grafting|grafted]] from the [[aorta]] to the [[coronary artery|coronary arteries]] to bypass [[atherosclerosis|atherosclerotic]] [[stenosis|narrowings]] and improve the [[blood]] supply to the [[coronary circulation]] supplying the [[myocardium]] ([[myocardium|heart muscle]]). This surgery is usually performed with the [[heart]] stopped, necessitating the usage of [[cardiopulmonary bypass]]. However, recent advances allow the procedure to be performed with the [[heart]] beating and through smaller [[incisions]]. Currently, about 500,000 [[Coronary artery bypass surgery]] ([[Coronary artery bypass surgery|CABG]]) are performed in the United States each year.


==Pathophysiology==
==Pathophysiology==
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==[[Coronary artery bypass surgery indications|Indications for CABG]]==
==[[Coronary artery bypass surgery indications|Indications for CABG]]==
[[Coronary artery bypass surgery in patients with acute MI|CABG in Patients with Acute MI]] | [[Coronary artery bypass surgery in ventricular arrhythmias|CABG in Patients with Ventricular Arrhythmias]] | [[Coronary artery bypass surgery after failed PCI|Emergency CABG after Failed PCI]] | [[Coronary artery bypass surgery in association with other cardiac procedures|CABG in Association with Other Cardiac Procedures]] | [[Coronary artery bypass surgery heart team approach to revascularization decisions|Heart Team Approach to Revascularization Decisions]] | [[Coronary artery bypass surgery of left main CAD to improve survival|Revascularization of Left Main CAD to Improve Survival]] | [[Coronary artery bypass surgery of non–left main CAD to improve survival|Revascularization of Non-Left Main CAD to Improve Survival]] | [[Coronary artery bypass surgery revascularization to improve symptoms|Revascularization to Improve Symptoms]]
[[Coronary artery bypass surgery in patients with acute MI|CABG in Patients with Acute MI]] | [[Coronary artery bypass surgery in ventricular arrhythmias|CABG in Patients with Ventricular Arrhythmias]] | [[Coronary artery bypass surgery after failed PCI|Emergency CABG after Failed PCI]] | [[Coronary artery bypass surgery in association with other cardiac procedures|CABG in Association with Other Cardiac Procedures]] | [[Coronary artery bypass surgery heart team approach to revascularization decisions|Heart Team Approach to Revascularization Decisions]] | [[Coronary artery bypass surgery of left main CAD to improve survival|Revascularization of Left Main CAD to Improve Survival]] | [[Coronary artery bypass surgery of non–left main CAD to improve survival|Revascularization of Non-Left Main CAD to Improve Survival]] | [[Coronary artery bypass surgery revascularization to improve symptoms|Revascularization to Improve Symptoms]] | [[Coronary artery bypass surgery CABG in left ventricular dysfunction|CABG in Left Ventricular Dysfunction]]


==[[Coronary artery bypass surgery prognosis|Prognosis]]==
==[[Coronary artery bypass surgery prognosis|Prognosis]]==
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==Imaging in the patient undergoing CABG==
==Imaging in the patient undergoing CABG==
[[Coronary artery bypass surgery X-ray|Chest x-ray]] | [[Coronary artery bypass surgery angiography|Coronary Angiography]]
[[Coronary artery bypass surgery X-ray|Chest x-ray]] | [[Coronary artery bypass surgery angiography|Coronary Angiography]]
|  [[Coronary artery bypass surgery CT angiography|CT Angiography]]  |  [[Coronary artery bypass surgery MR angiography|MR Angiography]] | [[Coronary artery bypass surgery TEE|Trans-Esophageal Echocardiography]]
|  [[Coronary artery bypass surgery CT angiography|CT Angiography]]  |  [[Coronary artery bypass surgery mri angiography|MRI Angiography]] | [[Coronary artery bypass surgery TEE|Trans-Esophageal Echocardiography]] | [[Coronary artery bypass surgery epiaortic ultrasound|Epiaortic Ultrasound]]


==[[Coronary artery bypass surgery goals of treatment|Goals of Treatment]]==
==[[Coronary artery bypass surgery goals of treatment|Goals of Treatment]]==


==[[Coronary artery bypass surgery perioperative medical therapy|Perioperative Medical Therapy]]==
==[[Coronary artery bypass surgery perioperative management|Perioperative and Intraoperative Management]]==
[[Coronary artery bypass surgery aspirin and clopidogrel|Aspirin and Clopidogrel]] | [[Coronary artery bypass surgery use of beta-blockers|Beta-Blockers]] | [[Coronary artery bypass surgery use of ACE Inhibitors/ARBs|ACE Inhibitors/ARBs]] | [[Coronary artery bypass surgery management of hyperlipidemia|Management of Hyperlipidemia]] | [[Coronary artery bypass surgery management of perioperative infection|Management of Mediastinitis/Perioperative Infection]] | [[Coronary artery bypass surgery percutaneous coronary intervention (PCI) to treat saphenous vein graft failure|Percutaneous Coronary Intervention (PCI) To Treat Saphenous Vein Graft Failure]] | [[Coronary artery bypass surgery postoperative antiplatelet therapy|Postoperative Antiplatelet Therapy]] | [[Coronary artery bypass surgery maintaining glucose level|Maintaining Glucose Level]]
[[Coronary artery bypass surgery aspirin and clopidogrel|Aspirin and Clopidogrel]] | [[Coronary artery bypass surgery use of beta-blockers|Beta-Blockers]] | [[Coronary artery bypass surgery use of ACE Inhibitors/ARBs|ACE Inhibitors/ARBs]] | [[Coronary artery bypass surgery management of hyperlipidemia|Management of Hyperlipidemia]] | [[Coronary artery bypass surgery management of perioperative infection|Management of Mediastinitis/Perioperative Infection]] | [[Coronary artery bypass surgery percutaneous coronary intervention (PCI) to treat saphenous vein graft failure|Percutaneous Coronary Intervention (PCI) To Treat Saphenous Vein Graft Failure]] | [[Coronary artery bypass surgery maintaining glucose level|Maintaining Glucose Level]] | [[Coronary artery bypass surgery bleeding/transfusion]] | [[Coronary artery bypass surgery management of dysrhythmias|Management of Dysrhythmias]] | [[Coronary artery bypass surgery smoking cessation|Smoking Cessation]] | [[Coronary artery bypass surgery perioperative management of myocardial dysfunction|Perioperative Management of Myocardial Dysfunction]] | [[Coronary artery bypass surgery perioperative carotid artery noninvasive screening|Perioperative Carotid Artery Noninvasive Screening]]


==[[Coronary artery bypass surgery perioperative monitoring|Perioperative Monitoring]]==
==[[Coronary artery bypass surgery perioperative monitoring|Perioperative and Intraoperative Monitoring]]==
[[Coronary artery bypass surgery electrocardiographic monitoring|Electrocardiographic Monitoring]] | [[Coronary artery bypass surgery pulmonary artery catheterization|Pulmonary Artery Catheterization]] | [[Coronary artery bypass surgery central nervous system monitoring|Central Nervous System Monitoring]] | [[Coronary artery bypass surgery anesthetic considerations|Anesthetic Considerations]] | [[Coronary artery bypass surgery bleeding/transfusion]] | [[Coronary artery bypass surgery management of dysrhythmias|Management of Dysrhythmias]] | [[Coronary artery bypass surgery smoking cessation|Smoking Cessation]] | [[Coronary artery bypass surgery perioperative management of myocardial dysfunction|Perioperative Management of Myocardial Dysfunction]] | [[Coronary artery bypass surgery perioperative carotid artery noninvasive screening|Perioperative Carotid Artery Noninvasive Screening]] |
[[Coronary artery bypass surgery electrocardiographic monitoring|Electrocardiographic Monitoring]] | [[Coronary artery bypass surgery pulmonary artery catheterization|Pulmonary Artery Catheterization]] | [[Coronary artery bypass surgery central nervous system monitoring|Central Nervous System Monitoring]]


==Surgical Procedure==
==[[Coronary artery bypass surgery surgical procedure|Surgical Procedure]]==
[[Coronary artery bypass surgery the traditional coronary artery bypass grafting procedure (simplified)| The Traditional Coronary Artery Bypass Grafting Procedure (Simplified)]] | [[Coronary artery bypass surgery minimally invasive CABG| Minimally Invasive CABG]] | [[Coronary artery bypass surgery conduits used for bypass|Conduits Used for Bypass]] | [[Coronary artery bypass surgery videos on spahenous vein graft harvesting| Videos on Spahenous Vein Graft Harvesting]] | [[Coronary artery bypass surgery videos on Coronary artery bypass surgery|Videos on Coronary Artery Bypass Surgery]] | [[Coronary artery bypass surgery hybrid coronary revascularization|Hybrid Coronary Revascularization]]
[[Coronary artery bypass surgery anesthetic considerations|Anesthetic Considerations]] | [[Coronary artery bypass surgery the traditional coronary artery bypass grafting procedure (simplified)| The Traditional Coronary Artery Bypass Grafting Procedure (Simplified)]] | [[Coronary artery bypass surgery minimally invasive CABG| Minimally Invasive CABG]] | [[Coronary artery bypass surgery conduits used for bypass|Conduits Used for Bypass]] | [[Coronary artery bypass surgery videos on spahenous vein graft harvesting| Videos on Saphenous Vein-Graft Harvesting]] | [[Coronary artery bypass surgery videos on Coronary artery bypass surgery|Videos on Coronary Artery Bypass Surgery]] | [[Coronary artery bypass surgery cardiopulmonary bypass|Cardiopulmonary Bypass]]


==[[Coronary artery bypass surgery post-operative complications|Post-Operative Complications]]==
==[[Coronary artery bypass surgery post-operative care and complications|Post-Operative Care and Complications]]==
 
[[Coronary artery bypass surgery postoperative antiplatelet therapy|Postoperative Antiplatelet Therapy]]
==Special scenarios==
==Special Scenarios==
[[Coronary artery bypass surgery in anomalous coronary arteries|Anomalous Coronary Arteries]] | [[Coronary artery bypass surgery in patients with COPD/respiratory insufficiency|Chronic Obstructive Pulmonary Disease/Respiratory Insufficiency]] | [[Coronary artery bypass surgery in patients with existing renal disease|Existing Renal Disease]] | [[Coronary artery bypass surgery in patients with valvular disease|Concomitant Valvular Disease]] | [[Coronary artery bypass surgery in patients with previous cardiac surgery|Previous Cardiac Surgery]] | [[Coronary artery bypass surgery in patients with menopause|Menopause]] | [[Coronary artery bypass surgery hybrid coronary revascularization|Hybrid Coronary Revascularization]]
[[Coronary artery bypass surgery in anomalous coronary arteries|Anomalous Coronary Arteries]] | [[Coronary artery bypass surgery in patients with COPD/respiratory insufficiency|Chronic Obstructive Pulmonary Disease/Respiratory Insufficiency]] | [[Coronary artery bypass surgery in patients with existing renal disease|Existing Renal Disease]] | [[Coronary artery bypass surgery in patients with valvular disease|Concomitant Valvular Disease]] | [[Coronary artery bypass surgery in patients with previous cardiac surgery|Previous Cardiac Surgery]] | [[Coronary artery bypass surgery in patients with menopause|Menopause]] | [[Coronary artery bypass surgery carotid disease evaluation before surgery|Carotid Disease Evaluation Before Surgery]]


==Related Chapters==
==Related Chapters==
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* [[Hybrid bypass]]
* [[Hybrid bypass]]


==External links==
==External Links==
*[http://www.texheartsurgeons.com/ Advances in Cardiovascular Surgery and Cardiothoracic Surgical Procedures]
*[http://www.texheartsurgeons.com/ Advances in Cardiovascular Surgery and Cardiothoracic Surgical Procedures]
*[http://www.ctsnet.org/residents/ctsn/ Cardiothoracic Surgery Notes] an online interactive review developed by residents in cardiothoracic surgery
*[http://www.ctsnet.org/residents/ctsn/ Cardiothoracic Surgery Notes] an online interactive review developed by residents in cardiothoracic surgery
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*[http://perfline.com/textbook/textbook.html The Virtual Textbook Of Extracorporeal Technology]  
*[http://perfline.com/textbook/textbook.html The Virtual Textbook Of Extracorporeal Technology]  
*[http://info.med.yale.edu/intmed/cardio/imaging/ Yale: Introduction to Cardiothoracic Imaging]
*[http://info.med.yale.edu/intmed/cardio/imaging/ Yale: Introduction to Cardiothoracic Imaging]
==References==
{{Reflist|2}}


[[Category:Cardiac surgery]]
[[Category:Cardiac surgery]]

Latest revision as of 06:26, 22 October 2022

For the WikiPatient page for this topic, click here

Coronary Artery Bypass Surgery Microchapters

Home

Patient Information

Overview

Pathophysiology

Saphenous Vein Graft Disease
Other Non-Atherosclerotic Saphenous Vein Graft Diseases

Indications for CABG

Prognosis

Diagnosis

Imaging in the Patient Undergoing CABG

Chest X Ray

Angiography

CT Angiography
MRI Angiography

Trans-Esophageal Echocardiography

Treatment

Goals of Treatment

Perioperative Management

Perioperative Monitoring

Electrocardiographic Monitoring
Pulmonary Artery Catheterization
Central Nervous System Monitoring

Surgical Procedure

Anesthetic Considerations
Intervention in left main coronary artery disease
The Traditional Coronary Artery Bypass Grafting Procedure (Simplified)
Minimally Invasive CABG
Hybrid coronary revascularization
Conduits Used for Bypass
Videos on Spahenous Vein Graft Harvesting
Videos on Coronary Artery Bypass Surgery

Post-Operative Care and Complications

Pharmacotherapy in patients undergoing CABG CABG

Special Scenarios

Anomalous Coronary Arteries
COPD/Respiratory Insufficiency
Existing Renal Disease
Concomitant Valvular Disease
Previous Cardiac Surgery
Menopause
Carotid Disease evaluation before surgery

Coronary artery bypass surgery On the Web

Most recent articles

Most cited articles

Review articles

CME programs

powerpoint slides

Images

Ongoing trials at clinical trials.gov

US National guidelines clearinghouse

NICE guidance

FDA on Coronary artery bypass surgery

CDC on Coronary artery bypass surgery

Coronary artery bypass surgery in the news

Blogs on Coronary artery bypass surgery|-

Directions to Hospitals Performing Coronary artery bypass surgery

Risk calculators for Coronary artery bypass surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Mohammed A. Sbeih, M.D. [2]; Anahita Deylamsalehi, M.D.[3]; Cafer Zorkun, M.D., Ph.D. [4]; Varun Kumar, M.B.B.S. [5] Prince Tano Djan, BSc, MBChB [6]

Synonyms and keywords: Coronary artery bypass grafting, and colloquially heart bypass, bypass, bypass surgery, open heart surgery, or CABG (pronounced like cabbage), aortocoronary bypass (ACB). The term Coronary Artery Graft Surgery (CAGS) is often used outside the United States and should not be confused with Coronary Angiography (CAG). OPCAB refers to Off-pump coronary artery bypass, a procedure during which the patient is not placed on extracorporeal circulation ("the pump").

Overview

Coronary artery bypass surgery (CABG) is a surgical revascularization procedure that is used to circumvent or bypass blockages in the epicardial coronary arteries associated with acute coronary syndromes (including ST elevation MI, non ST elevation MI, unstable angina) and stable angina. The technique was pioneered by Argentine cardiac surgeon René Favaloro at the Cleveland Clinic in the late 1960s. As part of the procedure, arteries or veins from elsewhere in the patient's body are grafted from the aorta to the coronary arteries to bypass atherosclerotic narrowings and improve the blood supply to the coronary circulation supplying the myocardium (heart muscle). This surgery is usually performed with the heart stopped, necessitating the usage of cardiopulmonary bypass. However, recent advances allow the procedure to be performed with the heart beating and through smaller incisions. Currently, about 500,000 Coronary artery bypass surgery (CABG) are performed in the United States each year.

Pathophysiology

Saphenous Vein Graft Disease | Other Non-Atherosclerotic Saphenous Vein Graft Diseases

Indications for CABG

CABG in Patients with Acute MI | CABG in Patients with Ventricular Arrhythmias | Emergency CABG after Failed PCI | CABG in Association with Other Cardiac Procedures | Heart Team Approach to Revascularization Decisions | Revascularization of Left Main CAD to Improve Survival | Revascularization of Non-Left Main CAD to Improve Survival | Revascularization to Improve Symptoms | CABG in Left Ventricular Dysfunction

Prognosis

Imaging in the patient undergoing CABG

Chest x-ray | Coronary Angiography | CT Angiography | MRI Angiography | Trans-Esophageal Echocardiography | Epiaortic Ultrasound

Goals of Treatment

Perioperative and Intraoperative Management

Aspirin and Clopidogrel | Beta-Blockers | ACE Inhibitors/ARBs | Management of Hyperlipidemia | Management of Mediastinitis/Perioperative Infection | Percutaneous Coronary Intervention (PCI) To Treat Saphenous Vein Graft Failure | Maintaining Glucose Level | Coronary artery bypass surgery bleeding/transfusion | Management of Dysrhythmias | Smoking Cessation | Perioperative Management of Myocardial Dysfunction | Perioperative Carotid Artery Noninvasive Screening

Perioperative and Intraoperative Monitoring

Electrocardiographic Monitoring | Pulmonary Artery Catheterization | Central Nervous System Monitoring

Surgical Procedure

Anesthetic Considerations | The Traditional Coronary Artery Bypass Grafting Procedure (Simplified) | Minimally Invasive CABG | Conduits Used for Bypass | Videos on Saphenous Vein-Graft Harvesting | Videos on Coronary Artery Bypass Surgery | Cardiopulmonary Bypass

Post-Operative Care and Complications

Postoperative Antiplatelet Therapy

Special Scenarios

Anomalous Coronary Arteries | Chronic Obstructive Pulmonary Disease/Respiratory Insufficiency | Existing Renal Disease | Concomitant Valvular Disease | Previous Cardiac Surgery | Menopause | Carotid Disease Evaluation Before Surgery

Related Chapters

External Links

References


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