Coronary artery bypass grafting (CABG) is a surgery for CAD. It's the most common heart surgery we do at Carilion. 

Your coronary arteries provide your heart with blood. When plaque builds up in the arteries, they narrow. Eventually, the blood can't flow as it should, which can lead to a heart attack. 

CABG uses blood vessels from other body parts and connects them above and below your blocked artery. This surgery is a bypass: the new blood vessel bypasses the blockage to get to the heart.

If you have coronary artery disease, you and your heart care team will talk about whether you need CABG. 

CABG helps treat people who: 

• Have several blocked coronary arteries
• Have a large build-up of plaque in the main coronary artery
• Have angina (chest pain) that doesn't improve with medicine
• Have had (or are having) a heart attack related to CAD
• Have diabetes along with CAD
• Have serious heart failure 

There are other treatments your doctor might try first. 

These include: 

• Lifestyle changes: For people who smoke, quitting is the number one thing you can do to improve your heart health. Your doctor may talk to you about diet and exercise as well. People with diagnosed CAD qualify for ​cardiac rehab, which we offer at Carilion.
• Medicine: Your doctor might prescribe medicines to lower cholesterol, reduce high blood pressure, slow the heartbeat or help reduce chest pain.
• Percutaneous coronary intervention: This nonsurgical procedure opens blocked arteries using a small balloon. The doctor also puts a stent in your artery to keep it open. This procedure is also called angioplasty with a stent.

For some people, CABG might be an emergency surgery to treat a heart attack. Others will discuss the surgery ahead of time and learn how to prepare. 

Before CABG 

Your doctor will order various tests before surgery. These include imaging to help the team learn more about your artery blockage. 

Your heart care team will give you specific instructions about what medicines to stop taking before surgery. They'll also discuss recovery and what to expect after surgery. 

During CABG 

The surgeon takes a healthy blood vessel from your arm, stomach, chest or leg and connects it to the coronary artery. You may only have one graft, or you may have several. 

CABG surgery usually takes 3 to 6 hours, depending on how many arteries the surgeon is bypassing. 

There are different approaches your surgeon may take. Your surgical team will decide what CABG procedure is best for you. 

Your surgeon may use a heart-lung bypass machine during the surgery. This artificial pump mimics your heart, keeping your blood flowing. 

After CABG 

After CABG, most people stay in the hospital for about a week. Immediately after the surgery, you'll go to our Cardiac Intensive Care Unit. 

There, our dedicated heart care staff will: 

• Monitor you 24/7
• Take care of your incision
• Connect you to devices to monitor your vital signs
• Take care of fluid draining from tubes
• Give you pain and other medicines 

At home, you'll keep taking certain medicines. Once you heal, your doctor will also prescribe cardiac rehab. 

Our Carilion Cardiac Rehabilitation program helps you recover faster, feel better and get healthier after heart surgery. Our trained specialists use exercise and wellness conditioning to help you regain strength and endurance. 

• Aerobic exercise to elevate your heart rate and improve blood flow
• Strength training to improve your muscle strength and stamina 

Traditional (open heart) CABG requires 6 to 12 weeks to recover fully. At that point, you’ll be able to return to work and daily activities. 

Every surgery carries risks. Your heart care team will talk to you about the general risks of surgery. With CABG, there are some other risks, too. 

These include: 

• Developing an irregular heartbeat (this sometimes corrects itself) 
• Heart attack 
• Stroke 
• Kidney problems, including kidney failure 
• Infection at the incision site or inside the chest 

People who have emergency CABG tend to have more risks than those who have a planned surgery. People with other conditions, such as diabetes, also have more risks.