Coronary artery bypass grafting (CABG), commonly called bypass surgery, is a major heart operation used to restore blood flow to heart muscle when coronary arteries are severely narrowed or blocked. At Livasa Hospital, CABG is performed by experienced cardiothoracic surgeons using advanced technology and evidence-based protocols to achieve strong clinical outcomes.

What is CABG?

In CABG, healthy blood vessels (grafts) from the chest, arm or leg are used to create new routes around blocked coronary arteries. This allows oxygen-rich blood to reach heart muscle beyond the blockages. Depending on the number of diseased arteries, patients may undergo:

• Single-vessel bypass

• Double-vessel bypass

• Triple-vessel or more complex bypass procedures

Surgical Team and Facility

CABG surgery at Livasa Hospital is carried out by:

• Board-certified cardiothoracic surgeons

• Cardiac anaesthesiologists

• Perfusionists managing the heart-lung machine

• Cardiac ICU specialists and trained nurses

Livasa Hospital Mohali serves as a major surgical hub within the Punjab network, with:

• Dedicated cardiac operating theatres

• Cardiopulmonary bypass and monitoring systems

• Comprehensive cardiac ICU facilities

Indications for CABG

CABG may be recommended in:

Types of CABG Techniques

• On-pump CABG: Surgery performed using the heart-lung machine with the heart temporarily stopped; offers a still, bloodless field for complex grafting.

• Off-pump CABG (beating-heart surgery): Selected cases may be done without the heart-lung machine; can benefit high-risk patients where appropriate.

• Minimally invasive and limited incision approaches: Used in select single-vessel cases such as isolated LAD disease.

Pre-operative Evaluation

Before surgery, patients undergo thorough assessment including:

• Coronary angiography review

• Echocardiogram to assess heart function and valves

• Routine blood tests, chest X-ray and ECG

• Pulmonary function tests in selected patients

• Anaesthesia evaluation and optimisation of comorbidities

Individual risk is assessed and explained, and patients and families are counselled regarding expected course and benefits.

The CABG Operation

Key stages of CABG include:

1. Administration of general anaesthesia and placement on the ventilator.

2. Opening the chest via median sternotomy or a smaller incision in selected cases.

3. Harvesting graft vessels such as internal thoracic arteries, radial arteries or saphenous veins.

4. Connecting the patient to the heart-lung machine (for on-pump CABG) and stopping the heart temporarily.

5. Sewing grafts beyond the blocked segments of coronary arteries.

6. Restarting the heart and gradually weaning off the heart-lung machine.

7. Ensuring thorough control of bleeding and placing drains.

8. Closing the sternum and chest in layers.

Graft Choices and Long-Term Patency

• Internal thoracic (mammary) artery grafts have excellent long-term patency and are preferred for critical vessels such as the left anterior descending artery.

• Saphenous vein grafts are commonly used for additional vessels and require optimal medical therapy to maintain patency.

• Radial artery grafts may be used as another arterial conduit in selected patients.

Post-operative Care in ICU

After surgery, patients are transferred to the cardiac intensive care unit where:

• Ventilator support is gradually reduced as the patient wakes up.

• Invasive monitoring tracks blood pressure, cardiac output and other parameters.

• Pain is controlled with appropriate medication.

• Fluid balance, kidney function and lung status are closely observed.

Most patients are shifted out of ICU within 24–48 hours, depending on recovery.

In-hospital Recovery

Typical hospital stay is 5–7 days and includes:

• Progressive mobilisation from bed to chair to corridor walking

• Removal of chest drains and pacing wires as appropriate

• Respiratory exercises and physiotherapy to improve lung function

• Education on wound care, activity restrictions and medications

Recovery at Home

Key guidance after discharge:

• First 2 weeks: Limited activity, short walks indoors, no driving, sleep with head slightly elevated if needed.

• Weeks 2–4: Gradual increase in walking distance; light household tasks; avoid lifting heavy objects.

• Weeks 4–6: Return to office work in many cases; supervised cardiac rehabilitation.

• Weeks 6–12: Progressive return to normal life, exercise and sexual activity as advised by the surgeon.

Medications After CABG

Long-term medicines usually include:

• Aspirin and possibly another antiplatelet agent

• Statins to control cholesterol and stabilise plaques

• Beta-blockers to control heart rate and blood pressure

• ACE inhibitors or ARBs in selected patients

• Diuretics in those with fluid overload or heart failure

Strict adherence to prescribed medication is essential to maintain graft patency and overall heart health.

Outcomes and Benefits

CABG aims to:

• Relieve angina and improve exercise capacity

• Reduce the risk of heart attack in selected groups

• Improve survival in high-risk anatomic and clinical subsets

• Enhance overall quality of life when combined with risk factor control

Why CABG at Livasa Hospital?

• Experienced surgical and cardiac anaesthesia teams

• NABH-accredited facility and robust infection control practices

• Post-operative ICU care tailored for cardiac patients

• Multidisciplinary support from cardiology, pulmonology, nephrology and rehabilitation teams

• Network support across Punjab for pre- and post-operative coordination

Schedule a CABG Consultation

For evaluation of complex coronary artery disease or second opinions on bypass surgery:

Livasa Hospital Mohali
Sector 71, Sahibzada Ajit Singh Nagar (SAS Nagar)
Mohali, Punjab – 160071
Phone: +91-80788 80788 (24/7 Emergency)
Website: www.livasahospitals.com

Call +91-80788 80788 to book a consultation with the cardiology and cardiothoracic surgery teams at Livasa Hospital.