CABG

Coronary Artery Bypass Graft

Summary

Indications

PreOperative Considerations

Case Study

60 year old male after witnessed cardiac arrest. ventricular fibrilatory arrest with subsequent

Key Terms

Acute Coronary Syndrome (ACS)
A spectrum of conditions associated with sudden, reduced blood flow to the heart. Includes ST-elevation MI (STEMI), non-ST-elevation MI (NSTEMI), and unstable angina.
Angina Pectoris
Chest discomfort or pain caused by reduced blood flow to the heart muscle.
Angioplasty
A procedure to widen narrowed or blocked blood vessels, often using a balloon catheter.
Bare Metal Stent (BMS)
A metal mesh tube placed in a coronary artery to keep it open.
Bilateral Internal Mammary Artery (BIMA) Grafting
The use of both the left and right internal mammary arteries for CABG.
Cardiopulmonary Bypass (CPB)
The use of a heart-lung machine to take over the function of the heart and lungs during surgery (on-pump CABG).
Chronic Coronary Syndrome (CCS)
Stable forms of CAD, often characterized by stable angina.
Chronic Total Occlusion (CTO)
A complete blockage of a coronary artery that has been present for an extended period (typically >3 months).
Coronary Artery Bypass Grafting (CABG)
A surgical procedure to improve blood flow to the heart muscle by creating new bypass routes around narrowed or blocked coronary arteries using grafts from other parts of the body.
Coronary Angiography
An imaging technique that uses X-rays and contrast dye to visualize the coronary arteries. Considered the gold standard for diagnosing CAD.
Coronary Artery Disease (CAD)
A condition in which the coronary arteries become narrowed or blocked, usually due to atherosclerosis.
Culotte Technique
A PCI technique for treating bifurcation lesions involving stenting both the main vessel and the side branch.
Drug-Eluting Stent (DES)
A stent coated with medication that is slowly released to prevent restenosis.
Fractional Flow Reserve (FFR)
A physiology-based assessment of the severity of a coronary artery narrowing, calculated from pressure measurements.
Heparin Resistance
A condition where the desired level of anticoagulation is not reached after standard heparin dosing.
Heparin-Induced Thrombocytopenia (HIT)
A serious immune-mediated complication of heparin therapy characterized by a decrease in platelet count.
Hibernating Myocardium
Myocardium that is chronically ischemic but still viable and can recover function after revascularization.
Internal Mammary Artery (IMA)
An artery located in the chest wall commonly used as a graft in CABG surgery due to its excellent long-term patency. Also referred to as the internal thoracic artery (ITA).
Intravascular Ultrasound (IVUS)
An imaging technique that uses a small ultrasound catheter to visualize the inside of blood vessels.
Ischemia
Insufficient blood flow to a tissue or organ, leading to a lack of oxygen.
J-CTO Score
A scoring system used to assess the complexity of chronic total occlusions and predict the likelihood of successful PCI.
Left Anterior Descending (LAD) Artery
A major coronary artery that supplies blood to the front and left side of the heart.
Left Circumflex (LCx) Artery
A major coronary artery that supplies blood to the back and side of the heart.
Left Main Coronary Artery
The main coronary artery that branches into the LAD and LCx. Significant stenosis in this artery is often a critical finding.
Left Ventricular (LV) Dysfunction
Impaired function of the left ventricle, the main pumping chamber of the heart.
Myocardial Infarction (MI)
Heart attack; death of heart muscle tissue due to prolonged ischemia.
Off-Pump CABG (OPCAB)
CABG surgery performed without the use of a cardiopulmonary bypass machine (beating heart surgery).
Patency
The condition of being open and unobstructed (referring to blood vessels or grafts).
Pedicled Graft
A graft conduit that is harvested while still attached to its original blood supply at one end.
Percutaneous Coronary Intervention (PCI)
A nonsurgical procedure to open narrowed or blocked coronary arteries, typically involving angioplasty and stent placement.
Prinzmetal's Angina
A type of angina caused by coronary artery spasm.
Provisional Stenting (PS)
A PCI strategy where a stent is initially placed only in the main vessel, with stenting of the side branch performed only if needed.
POBA
Radial Artery
An artery in the forearm that can be used as a graft in CABG surgery.
Redo CABG
A repeat CABG procedure in a patient who has previously undergone CABG.
Restenosis
The re-narrowing of a blood vessel after treatment, such as angioplasty or stenting.
Right Coronary Artery (RCA)
A major coronary artery that supplies blood to the right side and back of the heart.
Saphenous Vein Graft (SVG)
A segment of vein (usually from the leg) used as a graft in CABG surgery.
Skeletonized Graft
A graft conduit that is harvested by carefully dissecting away all surrounding tissue.
Stable Angina
Angina that occurs predictably with exertion and is relieved by rest or nitroglycerin.
Stent
A small, expandable mesh tube inserted into a blood vessel to hold it open.
Stunned Myocardium
Myocardium that is temporarily dysfunctional after a brief period of ischemia but is still viable and recovers function.
SYNTAX Score
A scoring system used to assess the complexity of coronary artery disease based on anatomical features observed during angiography.
T Stent Technique
A PCI technique for treating bifurcation lesions where a stent is placed in the side branch at a right angle to the main vessel stent.
Target Vessel Revascularization (TVR)
Any repeat revascularization procedure (PCI or CABG) performed on the previously treated vessel or graft.
Total Arterial Revascularization
CABG performed using only arterial grafts (two or more).
Transesophageal Echocardiography (TEE)
An ultrasound test performed through the esophagus to visualize the heart.
Unstable Angina
Angina that occurs unpredictably, at rest, or with less exertion, and is not relieved by rest or nitroglycerin, indicating a higher risk of MI.
Vein Graft Occlusion
Complete blockage of a saphenous vein graft.
Vein Graft Stenosis
Narrowing of a saphenous vein graft.

See Also

References