Surgical and Other Procedures for Coronary Artery Disease (CAD)
Surgery may be needed to treat severe CAD. It may also treat CAD that is causing angina despite treatment.
Coronary Artery Bypass Graft (CABG)
CABG is also known as open heart or bypass surgery. It is the most common type of heart surgery in the US.
A healthy blood vessel is removed from another area of the body. (A vein if it is from the leg, an artery if it is taken from the chest.) The healthy blood vessel is connected to the damaged artery. It is placed just above and just below the blocked area. This allows some blood to pass around the damaged area through the new pathway. If more than one area is blocked, a bypass can be done for each area. Two areas are called a double bypass, three is called triple bypass and so on.
Types of CABG include:
- Traditional CABG
- The heart is stopped for surgery.
- A heart-lung machine takes over the job of the heart until surgery is done.
- Off-pump CABG
- No heart-lung machine is needed.
- The surgeon works on the heart while it is still beating.
- Minimally invasive direct CABG
- Small incisions are made along the left side of the chest.
- May not be an option for everyone or widely available.
Talk to your doctor about which option is better for you. Although CABG may relieve symptoms, it does not cure heart disease. You still must maintain a healthy lifestyle. That includes reaching a healthy weight, heart healthy diet, not smoking, and taking medicine as needed.
Other procedures are used to open blocked arteries include:
- Coronary angioplasty —also called a percutaneous coronary intervention (PCI). A tube is inserted into the artery in your groin. It is passed up to blockage in the heart. There a balloon is quickly inflated and deflated. This opens the artery and improves blood flow. The balloon and catheter are then removed.
- Stent —A mesh stent may be placed in the artery during angioplasty. This will help to keep it open. The stent may be coated with a medicine. It will help to prevent blockage from coming back.
- Atherectomy —A tube is passed through blood vessels to the heart. Once the blockage is reached, a tool is used to slice the plaque away.
Cardiac procedures and surgeries. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartAttack/PreventionTreatmentofHeartAttack/Cardiac-Procedures-and-Surgeries_UCM_303939_Article.jsp#.Wp2C22rwbIU. Updated March 27, 2017. Accessed March 5, 2018.
Coronary artery bypass graft (CABG) surgery. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T113960/Coronary-artery-bypass-graft-CABG-surgery. Updated December 28, 2017. Accessed March 5, 2018.
Coronary artery bypass grafting. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/coronary-artery-bypass-grafting. Accessed March 5, 2018.
Percutaneous coronary intervention (PCI) procedure. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T915838/Percutaneous-coronary-intervention-PCI-procedure. Updated July 26, 2017. Accessed March 5, 2018.
Revascularization for coronary artery disease (CAD). EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T901116/Revascularization-for-coronary-artery-disease-CAD. Updated February 1, 2018. Accessed March 5, 2018.
Last reviewed March 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC Last Updated: 3/15/2015