Coronary Artery Bypass Surgery (CABG)

Coronary arteries are blood vessels that carry oxygen and nutrients to the heart.

Coronary artery bypass surgery (CABG) is an operation to improve the flow of blood to the heart muscle in people with coronary heart disease whose coronary arteries are severely narrowed or blocked. 

The operation involves taking blood vessels from other parts of the body and attaching them to the coronary arteries beyond the blockage. The blood is then able to flow around, or "bypass", the blockage. If more than one artery is blocked, you may need more than one bypass graft.

1. Stop smoking if you are a smoker. Smoking is a risk for coronary heart disease. Your heart disease will not improve if you continue to smoke. It also increases your risk of complications from the surgery.
2. Avoid traditional medicines (TCM, Jamu, Ayurvedic treatments) for at least 3 weeks before the operation, as these can increase the risk of bleeding or other complications of surgery. Your surgeon can advise when you may resume such remedies during your recovery after surgery.
3. Talk to your doctor or other people who have had the surgery. Knowing what to expect may help to reduce your anxiety before the operation.
4. Plan for your care and recovery after the operation. Allow for time to rest, and try to arrange for some help with meals and housework for the first 1-2 weeks at home.

1. CABG is performed by a team of surgeons.
2. The operation takes 3-6 hours, depending on how many blood vessels need to be bypassed.
3. A cut is made in the centre of the chest, at the breastbone, to allow the surgeon to see the heart.
4. Another cut may be made in your leg to remove a vein that will be put in your chest. In addition, an artery in the chest, called the internal mammary artery, can be used.
5. A cut may be made in your left arm to remove an artery that can sometimes be used for the bypass.
6. If a vein from your leg and/or artery from your arm is used, one end of it is sewn to the aorta (the main artery from the heart to the body). The other end is sewn to the area beyond the bloackage in the coronary artery.
7. In the case of the mammary artery, the lower end of this artery is cut and attached to the coronary artery beyond the blockage.
8. When the surgery is finished, your chest is closed with wires to the bone, and dissolving stitches will be used on the muscle and fat layer above the bone (including the skin).

1. You will go to the intensive care unit (ICU) where you will stay for at least 24 hours or as long as you need for observation. An electrocardiogram (ECG) monitor will record the rhythm of your heart continuously.
2. You will have respiratory therapy to prevent any lung problems, such as collapsed lung, infection, or pneumonia. A nurse or therapist will assess you will breathing exercises every few hours. Do ask for pain medication if you need it.
3. You will have physical therapy, which includes walking around the hospital and other strengthening activites. You will learn how to move your upper arms without hurting your breastbone.
4. You will learn how to live a healthy lifestyle, such as choosing foods that are low in fat, cholesterol and salt, exercising regularly and not smoking.

Seek medical attention if:

• you develop a fever.
• you become short of breath.
• you have chest pain that becomes worse despite taking painkillers.

Call the appointment hotline (6908 2222) during office hours if:

• you want to make another appointment.
• or email us at [email protected] if you have questions about the operation or its result.

1. If you are healthy and under the age of 60, your risk of serious complications is 1%. If you are older, and especially if you experience chest pains, your risk of serious complications is 2% to 10%.
2. There are always some risks when you have general anaesthesia, do discuss these risks with your doctor.
3. There is a risk of infection or bleeding from this operation.
4. There is a risk of stroke during and after the operation.
5. New blockages can develop in the bypassed vessels. This might require another heart catheterisation and surgery. Therefore, it is important to make changes to your lifestyle to decrease the risk of another blockage.