Coronary Artery Bypass Graft (CABG) Surgery

Which procedure involves a standard median sternotomy incision but is performed without cardiopulmonary bypass?

What is the main purpose of connecting the patient to the cardiopulmonary bypass (CPB) machine during CABG procedures?

What is one of the complications associated with Coronary Artery Bypass Graft (CABG) procedures?

What preoperative testing is typically done before a Coronary Artery Bypass Graft (CABG) procedure?

What is the goal of postoperative nursing management following CABG procedures?

What is the primary purpose of a Coronary Artery Bypass Graft (CABG) procedure?

What are the major indications for Coronary Artery Bypass Graft (CABG)?

What factors are considered when recommending a Coronary Artery Bypass Graft (CABG) procedure?

In what condition should the internal mammary artery be used for a Coronary Artery Bypass Graft (CABG) according to current guidelines?

What percentage of occlusion is required in the left main coronary artery for a patient to be considered for a Coronary Artery Bypass Graft (CABG) procedure?

Coronary Artery Bypass Graft (CABG)

CABG is a surgical procedure that grafts a blood vessel to an occluded coronary artery, allowing blood to flow beyond the occlusion.
The procedure aims to restore blood flow to the heart, relieve chest pain and ischemia, and improve the patient's quality of life.

Indications for CABG

Alleviation of angina that cannot be controlled with medication or PCI
Treatment for left main coronary artery stenosis or multi-vessel CAD
Prevention of and treatment for MI, dysrhythmias, or heart failure
Treatment for complications from an unsuccessful PCI

Factors Determine CABG Recommendation

Number of diseased coronary vessels
Degree of left ventricular dysfunction
Presence of other health problems
Patient's symptoms
Previous treatment

Procedure

Coronary arteries to be bypassed must have at least a 70% occlusion, or at least a 50% occlusion if in the left main coronary artery
Internal mammary artery is recommended for CABG, if possible
Saphenous vein is a commonly used vein for CABG

Traditional CABG

Performed with the patient under general anesthesia
Median sternotomy and cardiopulmonary bypass (CPB) machine are used
Blood vessel from another part of the patient's body is grafted distal to the coronary artery lesion, bypassing the obstruction

Alternative CABG

Off-pump coronary artery bypass (OPCAB) involves a standard median sternotomy incision, but without CPB
Beta-adrenergic blocker may be used to slow the heart rate
Myocardial stabilization device is used to hold the site still for the anastomosis of the bypass graft into the coronary artery while the heart continues to beat

Complications of CABG

Hemorrhage
Dysrhythmias
MI
Thromboembolic events

Preoperative Nursing Management

Performing a history and physical examination
Preoperative testing includes chest x-ray, ECG, laboratory tests, and blood typing and cross-matching
Obtaining consent form
Reducing fear and anxiety
Providing patient education

Postoperative Nursing Management

Achieving or maintaining hemodynamic stability and recovery from general anesthesia

Learn about the surgical procedure of Coronary Artery Bypass Graft (CABG), where a blood vessel is grafted to a blocked coronary artery to restore blood flow to the heart. Understand the purposes of CABG, which include relieving chest pain, improving quality of life, and reducing the risk of a heart attack.