# Coronary Artery Bypass Graft (CABG) > Citation bundle for Coronary Artery Bypass Graft (CABG) on The Treatment Registry. > URL: https://thetreatmentregistry.com/procedures/cabg > Bundle URL: https://thetreatmentregistry.com/api/citations/procedures/cabg - Category: cardiology - Average recovery: 56 days - Typical sessions: 1 - Price range (USD international): $7,000–$50,000 ## Description CABG surgery reroutes blood around blocked or narrowed coronary arteries using grafts harvested from the patient's chest, leg, or arm. It is typically recommended when coronary artery disease is severe or extensive, or when other treatments have failed. The procedure is performed under general anaesthesia with or without cardiopulmonary bypass. ## Overview Coronary artery bypass grafting is a major cardiac surgical procedure performed under general anaesthesia, typically lasting three to six hours depending on the number of bypasses required. In conventional on-pump surgery, the heart is arrested and cardiopulmonary bypass (the heart-lung machine) maintains systemic circulation while the surgeon constructs each bypass conduit. The left internal mammary (thoracic) artery is the preferred conduit for the left anterior descending artery bypass due to its superior long-term patency; the great saphenous vein from the leg and the radial artery from the forearm are used as supplementary conduits. In off-pump (beating-heart) surgery, bypasses are constructed on the still-beating heart using mechanical stabilisers, avoiding cardiopulmonary bypass. Patient selection is based on coronary angiography demonstrating significant stenosis in multiple vessels or in critical locations (left main disease, proximal three-vessel disease) where complete revascularisation by percutaneous coronary intervention is not appropriate. Left ventricular function, the presence of diabetes, and the extent of disease influence the decision between surgical and percutaneous approaches. Pre-operative optimisation of cardiac medications, renal function, and glycaemic control is important for reducing peri-operative risk. Post-operatively, patients are nursed in the intensive care unit for twenty-four to forty-eight hours before transfer to a high-dependency ward. Hospital stay is typically five to eight days. Sternal healing requires approximately six to eight weeks during which upper extremity loading is restricted. Patients should not drive for four to six weeks. Full functional recovery and return to normal activity typically takes two to three months. Cardiac rehabilitation — a structured exercise and education programme — is an evidence-based component of post-CABG care that significantly reduces re-admission rates and improves long-term outcomes. ## Peer-reviewed outcome rates - **Complication rate:** 10.00% (range 5.00–15.00%) — from 1 cited source - **Mortality rate:** 2.00% (range 1.00–4.00%) — from 2 cited sources ## Common risks - Stroke - Atrial fibrillation (irregular heart rhythm) - Wound infection (sternotomy or graft harvest site) - Kidney dysfunction - Cognitive changes (post-operative cognitive decline) - Graft failure (early or late occlusion) ## FAQs ### How long does a bypass graft last? The internal mammary artery graft — the preferred conduit for the most critical bypass — has a ten-year patency rate exceeding ninety per cent and frequently remains open for twenty years or more. Vein grafts have lower patency rates, with approximately fifty per cent remaining open at ten years. Adherence to cardiac medications and lifestyle modification significantly affects graft longevity. ### What is the difference between bypass surgery and a stent? A stent (percutaneous coronary intervention) is inserted via a catheter through the blood vessel to open a blockage from within, without open surgery. Bypass surgery creates a new route around the blockage using a harvested blood vessel. Bypass is generally preferred for extensive multi-vessel disease or left main artery blockages where stenting is less durable. ### How long will I be in hospital after CABG? Most patients spend five to eight days in hospital following CABG, including one to two days in the intensive care unit. The exact duration depends on the complexity of surgery, the patient's age and general health, and the absence or presence of post-operative complications such as atrial fibrillation or wound issues. ### Will I need to take medication for life after bypass surgery? Yes. Lifelong medications typically include antiplatelet therapy (aspirin), statins, beta-blockers, and often ACE inhibitors. These reduce the risk of graft failure, heart attack, and progression of coronary artery disease. Adherence to medication and risk factor management is a critical determinant of long-term outcomes. ### Can I drive after CABG? Driving is not permitted for four to six weeks after CABG, as the ability to perform an emergency stop is impaired during sternal healing and the patient may still be taking medications affecting alertness. Patients should also check with their driving licence authority, as notification of major cardiac surgery may be required in some countries. ### What is the mortality risk of bypass surgery? The mortality risk for elective CABG in a low-risk patient at a high-volume centre is approximately one to two per cent. Risk increases with age, emergency surgery, poor left ventricular function, and associated conditions such as kidney disease or diabetes. Patients should ask their surgeon for a risk estimate based on their individual profile. ### How soon can I return to normal activities after CABG? Light daily activities are possible within two to four weeks of discharge, though sternal precautions limit upper-body exertion for eight to twelve weeks. Return to sedentary work is typically possible at six to eight weeks, and cardiac rehabilitation — which begins four to eight weeks after discharge — progressively rebuilds exercise capacity. ### What lifestyle changes are necessary after bypass surgery? Bypass surgery treats blocked arteries but does not stop the underlying disease process. Long-term success requires smoking cessation, a heart-healthy diet low in saturated fat, regular moderate exercise, blood pressure and cholesterol management, and strict adherence to prescribed medications. Cardiac rehabilitation programmes provide structured support for these changes. ## Alternative treatments - **Percutaneous coronary intervention (angioplasty + stents)** — Less invasive alternative for single-vessel or selected multi-vessel disease; lower upfront mortality but higher repeat-revascularisation rate. - **Off-pump CABG** — Beating-heart variant; comparable outcomes in selected centres, lower CPB-associated morbidity. - **Optimal medical therapy alone** — Appropriate when symptoms are controllable and anatomy is not high-risk; no procedural risk. ## Sources - [STS Adult Cardiac Surgery Database](https://www.sts.org/registries/sts-national-database/adult-cardiac-surgery-database) — Society of Thoracic Surgeons (accessed 2026-05-09) - [2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization](https://www.ahajournals.org/doi/10.1161/CIR.0000000000001038) — American College of Cardiology / American Heart Association (accessed 2026-05-09) - [ESC — Guidelines on Myocardial Revascularization (CABG / PCI)](https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines) — European Society of Cardiology (accessed 2026-06-29)