Coronary artery bypass graft

Question 1

Define:

Answer 1

Surgical procedure to restore normal blood flow to the obstructed coronary artery

Can be done in two ways:

• left internal thoracic artery is diverted into the left anterior descending branch of the left coronary artery
• a great saphenous vein often taken from the leg, one end is attached to the aorta and the other end is attached to the obstructed vessel (just after the obstruction) to restore normal blood flow

Question 2

What is the procedure:

Answer 2

The heart is stopped and the blood is pumped artificially by a machine outside the body (cardiac bypass).

Patient’s saphenous vein or internal mammary artery is used in the graft

Several may be placed

> 50% will close after ten years

Question 3

Indications:

Answer 3

Left main stem disease

Multiple severe stenosis

Multi-vessel disease

failed or unsuitable angioplasty

Refractory angina that is unresponsive to drugs

If there is a choice between PCI and CABG NICE suggests using PCI

Question 4

Complications:

Answer 4

MI

Bleeding

Chest infections

Lung complications

Stroke