Coronary Artery Bypass Grafting (CABG)

Indications for CABG

CABG is indicated in cases of severe narrowing of the coronary arteries, coronary artery disease, and angina when medication is no longer effective. The procedure is also recommended for patients with significant damage to multiple arteries and for those who have had a myocardial infarction with a high risk of recurrence.

Contraindications for CABG

CABG is contraindicated in patients with severe comorbidities (such as terminal-stage cancer, severe kidney or liver failure), acute inflammatory processes, advanced heart failure, and in elderly patients with high surgical risks.

Preoperative Preparation

Preparation for CABG includes a comprehensive examination: blood tests, ECG, cardiac ultrasound, coronary angiography, and consultations with a cardiologist and anesthesiologist. Patients also receive medication and lifestyle adjustment recommendations prior to surgery.

How is the Procedure Performed?

CABG is performed under general anesthesia and can be done on a beating heart or using a heart-lung machine (cardiopulmonary bypass). The patient’s own blood vessels, usually the internal mammary artery or the great saphenous vein from the leg, are used as grafts.

Types of Coronary Artery Bypass Grafting

There are different techniques of CABG: traditional bypass surgery using a heart-lung machine and minimally invasive bypass surgery without stopping the heart. The latter method minimizes surgical trauma, speeds up recovery, and reduces the risk of postoperative complications. Modern minimally invasive techniques are used in Russian clinics, such as MICS CABG (Minimally Invasive Cardiac Surgery Coronary Artery Bypass Grafting) – minimally invasive coronary artery bypass grafting through a small lateral incision without opening the chest, MIDCAB (Minimally Invasive Direct Coronary Artery Bypass) – a type of MICS, usually used for bypassing the left anterior descending artery, and TECAB (Totally Endoscopic Coronary Artery Bypass) – a fully endoscopic bypass using robotic surgery. These technologies reduce surgical trauma, minimize pain, and allow the patient to return to an active life more quickly. The selection of the appropriate technique depends on the clinical situation and the capabilities of the medical center.

Advantages of Different CABG Methods

Traditional CABG is suitable for complex cases and provides full access to the heart. Minimally invasive methods offer faster recovery, less pain, and a reduced risk of infection. The method is selected based on the patient's health status and the complexity of coronary lesions.

Recovery After CABG

Rehabilitation after CABG is staged: it begins in the hospital under medical supervision and continues at home with gradually increasing physical activity. Patients undergo physiotherapy, therapeutic exercises, and receive dietary and medication recommendations.

Life After CABG

After CABG, most patients experience significant improvement in well-being and physical endurance. It is important to maintain a healthy lifestyle: quit smoking, control weight, monitor cholesterol levels and blood pressure, and regularly visit a cardiologist.

Where is the Best Place to Have CABG?

Coronary artery bypass surgery is performed at many leading cardiac surgery centers in Russia. The medical tourism platform Marus helps you choose highly reputable clinics with experienced surgeons and modern equipment.

Like any surgery, CABG may involve complications such as bleeding, infection, heart rhythm disturbances, stroke, or myocardial infarction. The risk depends on the patient's overall condition, the surgeon’s expertise, and the surgical method used. Following all medical recommendations is essential to minimize these risks.