Learn about Coronary Artery Bypass Graft (CABG) surgery: its purpose, procedure details, recovery process, and potential risks.

Heart disease has become one of the most common health challenges of modern life. Factors such as a sedentary lifestyle, high stress levels, and unhealthy eating habits often contribute to conditions like atherosclerosis, high blood pressure, and blocked arteries. Coronary Artery Bypass Graft (CABG) surgery is a widely performed and effective procedure to restore proper blood flow to the heart.

In this blog, we’ll explore what CABG surgery involves, the recovery process, possible risks, and essential tips for maintaining heart health after the procedure.

Understanding Coronary Artery Disease and CABG

Coronary arteries are the blood vessels to the heart. Due to atherosclerosis, plaque begins to accumulate in these arteries and narrows their lumen. If left unchecked, this process results in coronary artery blockage, compromising the cardiac blood flow. According to research, coronary heart disease is a prominent cause of death and disability globally. A large number of patients seek CABG surgery in Turkey every year due to the country’s reputation as a reliable medical tourism destination.

Coronary artery bypass surgery is the most commonly performed heart surgery globally. According to the statistics from the European Society of Cardiology (ESC), the number of CABG procedures in Turkey is the highest among all European countries.  

What is Coronary Artery Bypass Graft (CABG) Surgery?

CABG or coronary artery bypass surgery is a treatment for coronary heart disease. During the surgery, a healthy blood vessel from the body is harvested and used to bypass the blockage of the affected coronary artery to restore adequate blood flow to the heart.

Why is CABG Surgery Performed?

In accordance with international guidelines, Coronary Artery Bypass Grafting (CABG) in Turkey is typically performed in cases where there is significant narrowing or blockage of multiple coronary blood vessels. It is also indicated for patients experiencing angina that does not respond to medication, as well as those who have suffered a heart attack or myocardial infarction. 

Additionally, CABG may be recommended for individuals at increased risk of a heart attack or when the heart’s function is compromised, in order to improve blood flow and preserve cardiac health.

Conditions Leading to CABG

The main causes for people to seek heart bypass surgery include severe coronary artery disease (CAD), left main CAD, and both stable and unstable angina. Patients who have suffered a myocardial infarction or have triple vessel disease are also common candidates for the procedure. 

Additionally, heart bypass surgery may be necessary in cases of failed stent placement or angioplasty, severe heart failure associated with CAD, and for individuals with diabetes who have multivessel CAD. Restenosis, or the re-narrowing of previously treated arteries, is another significant reason for undergoing bypass surgery.

The CABG Surgical Procedure

Patients who seek a CABG suffer from symptoms of chest pain and shortness of breath. Similar to other cardiovascular surgeries, some things have to be done to prepare for a CABG surgery, such as:

Before Your CABG Surgery

Before your CABG surgery, a thorough pre-surgery evaluation is conducted, including a detailed medical history, physical examination, and necessary investigations. Medication management is also crucial, particularly in adjusting or stopping blood thinners and anti-hyperglycemic agents as advised by your healthcare team. 

Since the surgery is performed under general anesthesia, fasting for a specific period before the procedure is required. Additionally, making lifestyle changes such as quitting smoking and avoiding alcohol is essential to promote better surgical outcomes and recovery.

What Happens During CABG Surgery?

Coronary Artery Bypass Graft (CABG) is a major open-heart surgery designed to improve blood flow to the heart. The procedure generally involves the following steps:

1. Anesthesia – The patient is given general anesthesia to ensure they remain asleep and pain-free during the operation.

2. Incision – A midline sternotomy is performed, where the sternum (breastbone) is carefully divided to provide access to the heart and lungs.

3. Graft Harvesting – Healthy blood vessels are taken from other parts of the body, commonly from the leg (saphenous vein), arm (radial artery), or chest (internal mammary artery).

4. Heart-Lung Machine – In conventional CABG, a heart-lung machine is used to temporarily take over the function of the heart and lungs during surgery.

5. Graft Placement – The surgeon attaches the harvested vessel(s) to create a new route for blood to flow around the blocked artery.

6. Restoring the Heart – The patient is gradually weaned off the heart-lung machine, and normal heart function is restored.

7. Closing the Incision – The breastbone is wired back together, and the chest incision is closed carefully.

Different Types of CABG Surgery

The different types of CABG surgery include a range of advanced and specialized procedures. Conventional CABG involves the use of a heart-lung machine to take over the function of the heart during surgery. Off-pump CABG, on the other hand, is performed without the need for a heart-lung machine, reducing certain risks associated with the procedure. 

Patients may undergo triple bypass surgery when three coronary arteries are affected. Minimally Invasive CABG Surgery (MICS) is an option that uses smaller incisions for quicker recovery. Robotics-assisted CABG offers enhanced precision through robotic technology, while CABG combined with CPI (Percutaneous Coronary Intervention) provides a hybrid approach for treating complex coronary artery disease.

Recovery After CABG Surgery

Recovery from Coronary Artery Bypass Graft (CABG) surgery is a gradual process. Most patients need about 3 to 6 months to fully heal, depending on their overall health and any existing conditions. 

Immediate Post-Operative Care

Immediate post-operative care following CABG surgery is critical to ensure a smooth recovery. Patients are closely monitored in the ICU during this initial period, where vital signs and heart function are carefully observed. Breathing support through a ventilator is often provided for a few hours after surgery, followed by guided breathing exercises to strengthen lung function. Effective pain management is essential for comfort and healing, while careful fluid management helps maintain balance in the body. Early mobilization is encouraged to reduce the risk of complications and promote quicker recovery.

Your Hospital Stay and Initial Recovery

Heart surgery recovery is an extensive process. For example, after a CABG in Istanbul, patients stay in the hospital for 5 days to a week. The first couple of days are spent in the ICU for close monitoring to ensure proper recovery. The rest of the days are spent at the regular cardiac unit recovery. 

The discharge criteria following CABG surgery include the patient’s ability to walk independently for short distances and perform daily activities such as using the bathroom and eating without assistance. Heart function must be stable, and the patient should be able to take prescribed medications correctly. Additionally, a clear understanding of follow-up care and post-surgical instructions is essential before being discharged from the hospital.

Returning to Normal Activities

Getting a CABG for a blocked heart artery is a major surgery. The recovery is slow and gradual. Most patients can resume some normal activities as early as 6 to 12 weeks. The general consensus is to pace yourself. Avoid any stressful and high-impact activities for at least 12 weeks. Attend follow-up cardiac rehabilitation sessions diligently for maximum success.

Long-Term Recovery and Lifestyle Changes

Following recovery, certain lifestyle modifications can significantly improve the chances of long-term success after CABG surgery. Maintaining a healthy and nutritious diet supports heart health and overall well-being. Reducing stress through relaxation techniques or counseling is also beneficial. 

Quitting smoking is essential, as it greatly reduces the risk of further cardiac complications. Adopting an active lifestyle with regular physical activity enhances cardiovascular fitness, while routine health check-ups help monitor recovery and detect any early signs of issues, ensuring continued progress and heart health. 

Potential Risks and Complications of CABG

Although Coronary Artery Bypass Graft (CABG) surgery is generally safe and highly effective, some risks and complications can occur. Regular follow-up and cardiology evaluations are essential to minimize these risks.

Common Side Effects and Minor Complications

Mild side effects are common after CABG and usually improve with time. These may include:

• Chest pain or soreness

• Shortness of breath

• Low-grade fever

• Temporary irregular heartbeat (arrhythmia)

• Swelling or bruising in the legs (where the graft was taken)

• Emotional changes or mood swings

Serious Risks Associated with CABG Surgery

Although rare, some serious complications may develop:

• Blockage or failure of the graft

• Persistent irregular heart rhythms

• Heart failure

• Anxiety or depression

• Chronic pain at the incision site

Factors That Increase Surgical Risk

Certain conditions can make CABG surgery riskier, such as:

• Age over 70

• Reduced heart function

• Diabetes, uncontrolled high blood pressure, or kidney disease

• Chronic lung disease

• Smoking

• Multiple blocked arteries

• Previous heart surgeries

• Emergency procedures

Alternatives to CABG Surgery

While CABG is the gold standard for severe or multi-vessel coronary artery disease, some patients may not be suitable candidates due to age, medical conditions, or personal preference. In such cases, the following alternatives can be considered:

Coronary Angioplasty and Stenting

This minimally invasive procedure involves threading a thin, flexible catheter through a blood vessel to the site of the blockage. A small balloon at the tip is inflated to open the artery, and a stent (a tiny mesh tube) is placed to keep the vessel open and maintain blood flow.

CABG vs. Angioplasty

CABG is often recommended for patients with multiple blocked arteries or complex heart disease, while angioplasty is usually more suitable for single or less severe blockages.

Medical Park Hospitals in Turkey are among the most trusted centers for cardiovascular surgery, including CABG and other advanced procedures. With over 27 hospitals nationwide, a 5,300-bed capacity, more than 2,500 qualified medical professionals, and 210 fully equipped surgical rooms, Medical Park ensures high-quality care and patient safety. 

Along with CABG, MedicalPark Hospitals provide advanced interventional treatments like cardiac ablation for arrhythmia. For more information, visit our Cardiovascular Surgery department page. Our expert surgeons perform advanced procedures for complex heart conditions.

This content was developed by the MedicalPark Editorial Board and is intended for informational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Please consult your healthcare provider for personalized care.