PreOp Patient Education
Monday, November 30, 2020

  Your Body
  Medical Record
  Before Surgery
  Your Procedure

Coronary Artery Bypass Graft

(CABG off-pump)

Your Procedure

This information is not intended to replace the advice of your doctor. MedSelfEd, Inc. disclaims any liability for the decisions you make based on this information.
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Now it's time to talk about the actual procedure your doctor has recommended for you.

On the day of your operation, you will be asked to put on a surgical gown.
You may receive a sedative by mouth ...
... and an intravenous line may be put in.
You will then be transferred to an operating table.
In the operating room, a nurse will begin preparation by clipping or shaving the chest area and the part of the body from which the graft vessel or vessels will be removed.
The anesthesiologist will begin to administer anesthesia - most probably general anesthesia by injection and inhalation mask.
The surgeon will then apply an antiseptic solution to the skin ...
... and place a sterile drape around the operative site.
One or more sections of blood vessel will be taken from the leg, thigh or chest wall and the incision at those points will be sutured and bandaged.
Then, your doctor will make a vertical incision in the center of the chest.
Skin and other tissue will be pulled back in order to expose the breast bone.
Your doctor will carefully divide the breast bone ...
... and a special instrument called a retractor will be used to hold the chest open.
Once your doctor has a clear view of the heart, he or she will make an incision in the pericardium - a thin membrane that encloses the heart.
Pulling the pericardium back will reveal the beating heart.
Next, the surgeon will gently rotate the heart to the right in order to allow access to the heart’s underside.
Using veins taken from another part of your body, the team will begin to build new paths for blood – bypassing the blocked areas of the old artery or arteries. The team will attach as many new veins as needed to the underside of the heart.
Then, the doctor will gently rotate the heart back to its normal position.
To complete the bypass graft procedure, your doctor attaches the ends of the new veins on either side of the diseased area or areas of the old coronary artery. Blood can now flow freely – avoiding the clogged areas that had caused your symptoms.
The pericardium can now be closed over the heart.
Your doctor will position two special drainage tubes in the chest cavity.
These tubes prevent fluid from building up around the heart during the healing process.
The breast bone is then closed with metal wire ...
... and the remaining tissue is closed with sutures.
Finally a sterile bandage is applied.

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