coronary artery bypass grafting

Imagine a highway blocked by an accident; rather than clearing the wreck, engineers build a detour road that routes traffic around it. Coronary artery bypass grafting (CABG) does this for the heart: a surgeon uses a healthy blood vessel from elsewhere in the body to carry blood around a blocked segment of a coronary artery, restoring supply to the heart muscle beyond.

The surgeon harvests a graft — commonly an artery from inside the chest wall (the internal mammary artery) or a vein from the leg — and sews one end to the aorta or a chest-wall artery and the other beyond the blockage. Several grafts may be placed in one operation. Traditionally the heart is stopped and a cardiopulmonary bypass machine takes over circulation while the delicate stitching is done, though some operations are performed on a still-beating heart.

CABG is a major open-chest operation, used when blockages are numerous, complex, or affect the left main artery, and often favored in people with diabetes. Compared with stenting, it can offer more durable relief in advanced multivessel disease, at the cost of a bigger procedure and longer recovery. As with PCI, it reroutes blood but does not stop atherosclerosis, so prevention and medication remain essential afterward.