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CABG

Coronary Artery Bypass Surgery (CABG)

Restoring blood flow to the heart by bypassing blocked coronary arteries

Overview

Coronary Artery Bypass Grafting (CABG) is a surgical procedure that restores blood flow to the heart muscle by creating a detour around blocked or narrowed coronary arteries. It is one of the most commonly performed and well-established cardiac surgeries worldwide.

Coronary artery disease (CAD) occurs when plaque builds up within the walls of the coronary arteries, narrowing them and reducing blood flow to the heart muscle. This can lead to chest pain (angina), shortness of breath, and if left untreated, heart attack.

In CABG surgery, a healthy blood vessel (graft) is taken from another part of the body — typically the chest wall, leg, or arm — and connected to the coronary artery beyond the blockage, creating a new pathway for blood to reach the heart muscle.

Dr. Nisarga has extensive experience in performing CABG using multiple approaches including traditional on-pump, off-pump (beating heart), and minimally invasive techniques.

Key Facts

5–7 days

Typical Hospital Stay

90%+

LIMA Graft Patency at 10 Years

6–8 weeks

Sternal Precautions

99%

Off-Pump Rate in Suitable Patients

Conditions Treated

Coronary Artery Bypass Surgery (CABG) is used to treat the following conditions

Left Main Coronary Artery Disease

Significant blockage in the main artery supplying the left heart

Multi-Vessel Coronary Artery Disease

Blockages in two or more coronary arteries

Complex Coronary Lesions

Difficult blockages not suitable for stent placement

Diabetes with Diffuse CAD

Patients with diabetes who often have more extensive disease

Failed Prior Stent

Recurrent blockage at the site of a previously placed stent

Symptoms

Patients with conditions requiring CABG may experience one or more of the following symptoms. It is important to note that some conditions may be asymptomatic in their early stages.

Chest pain or discomfort (angina) — often described as pressure, squeezing, or fullness
Shortness of breath, especially during physical activity
Fatigue and reduced stamina
Pain radiating to the arms, shoulder, neck, jaw, or back
Heart palpitations or irregular heartbeat
Dizziness or lightheadedness
Nausea or indigestion

Important: These symptoms can also be caused by other medical conditions. If you experience any of these symptoms, please consult a qualified healthcare professional for an accurate diagnosis.

Diagnosis

A thorough diagnostic evaluation is essential for accurate diagnosis and treatment planning

Detailed medical history and physical examination
Electrocardiogram (ECG) to detect signs of reduced blood flow or prior heart attack
Echocardiogram to assess heart function and wall motion abnormalities
Coronary angiography (cardiac catheterization) — the gold standard for identifying blockages
CT coronary angiography for non-invasive evaluation
Stress testing (exercise or pharmacological) to assess functional significance of blockages
Blood tests including lipid profile, cardiac enzymes, and diabetic screening

Treatment Options

The choice of treatment depends on the specific condition, its severity, and individual patient factors

Lifestyle Modifications

Diet, exercise, smoking cessation, and risk factor management

Medical Management

Medications including antiplatelets, statins, beta-blockers, and nitrates

Percutaneous Coronary Intervention (PCI)

Angioplasty and stent placement for suitable blockages

Coronary Artery Bypass Surgery (CABG)

Surgical bypass of blockages using arterial or venous grafts

Surgical Approach

How the procedure is performed by Dr. Nisarga and his team

1

Dr. Nisarga evaluates each patient to determine the optimal surgical approach — on-pump, off-pump, or minimally invasive.

2

Healthy graft vessels are harvested — typically the left internal mammary artery (LIMA) from the chest and/or saphenous vein from the leg.

3

For on-pump CABG: The heart is temporarily stopped and a heart-lung machine maintains circulation while grafts are attached.

4

For off-pump CABG (beating heart): The heart continues beating while specialized stabilizers immobilize the area being grafted.

5

The LIMA graft is typically connected to the left anterior descending (LAD) artery — the most important coronary vessel.

6

Additional vein or arterial grafts are connected to other blocked coronary arteries to achieve complete revascularization.

7

The grafts are checked for adequate flow before completing the procedure.

Benefits

Why patients and physicians choose CABG

Complete revascularization of all significantly blocked coronary arteries
Durable, long-lasting results — LIMA grafts have 90%+ patency at 10 years
Significant relief from angina and improvement in quality of life
Reduced risk of heart attack and improved long-term survival
Less need for repeat procedures compared to stenting in multi-vessel disease
Particularly beneficial for patients with diabetes and complex coronary disease
Can be performed off-pump to reduce complications in high-risk patients

Recovery & Rehabilitation

What to expect during the recovery period after CABG

ICU stay of 24–48 hours for close monitoring following surgery.
Total hospital stay is typically 5–7 days for traditional CABG.
Gradual mobilization begins within 24–48 hours after surgery.
Sternal precautions are necessary for 6–8 weeks to allow bone healing (for sternotomy approaches).
Cardiac rehabilitation is an essential component of recovery — typically starting 4–6 weeks post-surgery.
Return to sedentary work is often possible within 6–8 weeks.
Lifelong medications including antiplatelets, statins, and heart failure therapy are typically required.
Regular follow-up with stress testing or imaging is recommended to monitor graft patency.

A Word from Dr. Nisarga

For select patients with less extensive coronary disease, robotic or minimally invasive CABG (MICS CABG) may be an option. This approach avoids full sternotomy, resulting in less pain, shorter hospital stay, and faster recovery. Dr. Nisarga carefully evaluates each patient to determine if they are candidates for these less invasive bypass techniques.

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Take the first step towards advanced cardiac care. Dr. Nisarga and his team are here to help.

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