By: Abdi Waluyo Hospital

Overview

What is Coronary Artery Bypass Grafting (CABG)?

Coronary Artery Bypass Grafting (CABG), commonly known as heart bypass surgery, is a surgical procedure performed to restore blood flow to the heart muscle in patients with significant narrowing or blockage of the coronary arteries.

Coronary artery disease occurs when fatty deposits (plaques) build up inside the coronary arteries, reducing blood flow and oxygen supply to the heart. When these blockages become severe, patients may experience chest pain (angina), shortness of breath, heart failure, or even a heart attack.

During CABG, a cardiac surgeon creates a new pathway (“bypass”) for blood to flow around the blocked artery by using a healthy blood vessel taken from another part of the body, such as the internal mammary artery (IMA), radial artery, or saphenous vein from the leg. This restores adequate blood flow to the heart muscle, relieves symptoms, and reduces the risk of future cardiac events.

CABG remains the gold standard treatment for many patients with complex coronary artery disease, particularly those with multiple blocked arteries, left main coronary artery disease, diabetes, or reduced heart function.

At RS Abdi Waluyo, CABG is performed by an experienced Cardiac Surgery Team using advanced surgical techniques and supported by a state-of-the-art Hybrid Catheterization Laboratory (Hybrid Cath Lab). A multidisciplinary Cardiac Team collaborates to determine the most appropriate treatment strategy for each patient.

Why is CABG Performed?

Your cardiologist or cardiac surgeon may recommend CABG if you have:

Severe coronary artery disease involving one or more coronary arteries.
Significant narrowing of the left main coronary artery.
Triple-vessel coronary artery disease.
Coronary artery disease associated with diabetes.
Persistent chest pain despite optimal medical therapy.
Coronary artery disease not suitable for angioplasty or stent placement.
Reduced heart function due to poor blood supply.
Certain emergency situations following a heart attack.

The goal of CABG is to improve blood flow to the heart, relieve symptoms, improve quality of life, preserve heart function, and reduce the risk of heart attack and death.

Details of the Procedure

Before surgery, your healthcare team will perform a comprehensive evaluation that may include:

Consultation with a cardiologist and cardiac surgeon.
Physical examination and medical history review.
Blood tests.
Electrocardiography (ECG).
Coronary Angiography.
Cardiac CT scan when indicated.
Chest X-ray.
Pulmonary function tests when appropriate.

Before surgery, you may be instructed to:

Fast for several hours.
Temporarily discontinue certain medications such as blood thinners.
Stop smoking.
Inform your doctor about allergies or other medical conditions.

CABG typically takes 3 to 6 hours, depending on the number of bypass grafts required and the complexity of the surgery.

What Happens During the Procedure?

During CABG:

General anesthesia is administered.
The cardiac surgeon accesses the heart through the chest.
Healthy blood vessels are harvested from the chest, arm, or leg.
The surgeon creates one or more bypass grafts around the blocked coronary arteries.
Depending on the patient’s condition, the operation may be performed using a heart-lung machine (on-pump CABG) or on the beating heart (off-pump CABG).
Blood flow is restored to the heart muscle through the new grafts.
After confirming satisfactory blood flow, the surgical incision is closed.

Throughout the procedure, your heart rhythm, blood pressure, oxygen level, and other vital signs are continuously monitored.

The Role of the Hybrid Cath Lab

At RS Abdi Waluyo, CABG is supported by an advanced Hybrid Catheterization Laboratory (Hybrid Cath Lab) that integrates high-resolution cardiovascular imaging with a modern cardiac operating environment.

The Hybrid Cath Lab provides several important advantages:

Advanced real-time imaging for improved procedural planning and precision.
Seamless collaboration between cardiac surgeons and interventional cardiologists.
The ability to perform hybrid coronary revascularization, combining minimally invasive bypass surgery with coronary angioplasty and stenting when appropriate.
Immediate access to catheter-based interventions if required during surgery.
Enhanced patient safety through integrated imaging, surgical, and anesthetic capabilities.
A multidisciplinary Heart Team approach that ensures individualized treatment planning based on each patient’s coronary anatomy and overall health.

What Should I Expect After Surgery?

After CABG:

You will recover initially in the Intensive Care Unit (ICU).
Most patients are transferred to a regular cardiac ward within one to two days.
Hospital stay generally ranges from 5 to 7 days, depending on recovery.
Walking and light activity are encouraged early to promote healing.
Full recovery usually takes 6 to 12 weeks, although this varies among patients.

Your healthcare team will provide instructions regarding medications, wound care, activity restrictions, diet, and cardiac rehabilitation.

What Are the Risks?

CABG is a well-established procedure with excellent long-term outcomes. However, as with any major surgery, potential risks include:

Heart attack.
Abnormal heart rhythms (arrhythmias).
Blood clots.
Lung complications.
Kidney dysfunction.
Memory or temporary cognitive changes.
Death (rare).

Your surgical team carefully evaluates each patient to minimize these risks.

Results and Follow-Up

Following CABG, your cardiac surgeon and cardiologist will evaluate:

Blood flow through the bypass grafts.
Relief of angina symptoms.
Improvement in heart function.
Recovery of physical activity.
Long-term cardiovascular health.

Follow-up care includes:

Regular cardiology consultations.
Electrocardiography (ECG).
Medication optimization.
Cardiac rehabilitation.
Lifestyle modification to reduce cardiovascular risk.

When Will I Know the Results?

Your cardiac surgeon will discuss the initial results shortly after surgery.

During your hospital stay, additional clinical assessments and imaging studies will evaluate the success of the bypass grafts and monitor your recovery before discharge.

If the Results Are Abnormal, What Are the Next Steps?

If additional treatment is required, your Heart Team may recommend:

Medication adjustments.
Additional cardiac imaging.
Coronary CT Angiography.
Coronary Angiography.
Percutaneous Coronary Intervention (PCI) with angioplasty and stenting.
Repeat surgery in selected cases.
Ongoing cardiac rehabilitation and follow-up.

Treatment recommendations will depend on your coronary anatomy, symptoms, and overall health.

When Should I Call My Doctor?

Contact your doctor immediately if you experience:

Increasing chest pain.
Shortness of breath.
Redness, swelling, or drainage from the surgical incision.
Persistent palpitations.
Leg swelling.
Sudden weakness or dizziness.
Any new or worsening symptoms.

Seek emergency medical attention immediately if you develop severe chest pain, stroke symptoms, difficulty breathing, or loss of consciousness.

Why Choose RS Abdi Waluyo for CABG?

At RS Abdi Waluyo, our Cardiac Surgery Program combines internationally accepted surgical techniques, advanced technology, and multidisciplinary expertise to deliver outstanding outcomes for patients with coronary artery disease.

Our CABG program offers:

Advanced Hybrid Catheterization Laboratory (Hybrid Cath Lab) integrating modern cardiac surgery with advanced cardiovascular imaging.
Experienced cardiac surgeons specializing in coronary artery bypass surgery and complex cardiovascular procedures.
Comprehensive Cardiac Team collaboration, involving cardiologists, interventional cardiologists, cardiac surgeons, cardiac imaging specialists, anesthesiologists, intensivists, and cardiac rehabilitation specialists.
Hybrid coronary revascularization, combining minimally invasive surgery and catheter-based coronary intervention for selected patients.
Comprehensive preoperative evaluation and individualized treatment planning.
Advanced postoperative intensive care and cardiac rehabilitation programs.
Integrated cardiovascular services, from diagnosis and coronary angiography to surgery, rehabilitation, and lifelong follow-up.
A patient-centered approach focused on safety, clinical excellence, faster recovery, and long-term heart health.

By combining advanced surgical expertise, state-of-the-art Hybrid Cath Lab technology, and a multidisciplinary Cardiac Team approach, RS Abdi Waluyo provides comprehensive Coronary Artery Bypass Grafting (CABG) services, helping patients achieve improved heart function, lasting symptom relief, and better long-term cardiovascular outcomes.