Multi-Arterial Coronary Artery Bypass Grafting

Multi-arterial coronary artery bypass grafting (CABG) is a surgery that uses more than one artery to bypass blocked blood vessels. This procedure is associated with reduced chances of mortality, repeated surgery and heart attack or heart failure in certain patients. Multi-arterial CABG may be recommended if medications, lifestyle changes and other non-invasive approaches may not be enough to treat certain cardiovascular conditions.

At Baptist Medical Network, we take matters of the heart very seriously. We thoroughly assess a patient’s overall health, heart condition and other factors to recommend appropriate treatment options for them. Our team of cardiovascular experts is composed of cardiologists, heart specialists, cardiovascular surgeons and nurses.

What Is Multiple Arterial Grafting

A study published by the American Heart Association found that using two or more arterial grafts (multi-arterial CABG) is associated with better outcomes compared to using just one arterial graft. To better understand multi-arterial CABG, let’s learn about typical coronary artery bypass grafting.

Coronary artery bypass graft (CABG) surgery is a heart blockage treatment that can address plaque buildup. Plaque is comprised of any substance made up of cholesterol, fat and other substances found in the blood. When plaque builds up in the coronary arteries, it can partially or completely block the flow of oxygen-rich blood to the heart. A typical CABG is performed using a single artery graft, while multiple-arterial CABG involves using two or more arterial grafts.

Performed via open-heart surgery, the CABG procedure creates an alternative route for blood to flow to the heart. This may improve the blood and oxygen flow to the heart, relieve chest pain and reduce the risk of a heart attack. CABG involves the use of grafts or veins and arteries taken from other parts of your body. This will not substantially affect the blood flow in the area where the grafts came from.

A surgeon will use these grafts to create a new blood passage around the clogged artery. If more than three coronary arteries must be addressed in a single operation, the procedure is called triple bypass surgery. The surgeons will perform quintuple open-heart bypass surgery if all five major heart arteries are affected.

Who Needs CABG

Non-invasive treatment options may not work for some patients with the following conditions, so CABG may be considered:

Coronary heart disease (CHD) with chest pain (angina) that medications were not able to treat
History of cardiac arrest due to irregular heartbeat (arrhythmia)
Heart attack related to coronary artery disease (CAD) that cannot be treated properly with percutaneous coronary intervention (PCI)
Multiple blocked coronary arteries due to plaque
Severe heart failure

The choice between single-arterial and multiple coronary artery bypass graft procedures typically depends on a range of patient-specific factors, including overall health, severity of heart condition and other surgical risk factors. Your heart care team will thoroughly discuss your treatment options to determine whether CABG would be an appropriate treatment for your condition. Your team may include a cardiologist (heart doctor) and a cardiothoracic surgeon, who specializes in surgical procedures performed on the heart, lungs and chest.

Preparing for CABG Surgery

Heart bypass surgery can be either a planned procedure or an emergency response, often following a heart attack that results in severe heart failure. If your surgery is scheduled, it's essential to understand what to expect and how to get ready. Preparing for CABG surgery involves clear communication with your healthcare team, understanding the steps you need to take before the surgery and being informed about the procedure and recovery. Your doctor is there to support you every step of the way, ensuring you are comfortable and well-prepared.

Here are some things to confirm with your doctor before surgery:

Confirm which medications and supplements you should stop taking and the appropriate timing to cease them. Ask your doctor if there are any new medications you need to start and when to begin them.
Ask about any special bathing instructions before surgery, such as the use of specific soaps.
Determine when you should stop eating and drinking before your procedure.
Clarify the time you need to arrive at the hospital and the exact location where you should check in.
Understand what you can expect immediately after the surgery and during the recovery period.

Before the procedure, your doctor may perform heart imaging tests to evaluate the severity of your coronary artery disease and pinpoint where the arteries are narrowed. This information helps in planning the surgery effectively. Your doctor will explain the surgery process, treatment options and discuss the potential risks and complications associated with CABG.

Don’t hesitate to ask your doctor any questions you have. This is your opportunity to gather all necessary information to make well-informed decisions about your treatment.

How Is Coronary Artery Bypass Graft Surgery Done

CABG may be performed as minimally invasive or open-heart surgery. In minimally invasive CABG, the surgeon makes small cuts on the side of the chest between the ribs. A patient may or may not have to be on a bypass machine during operation. This procedure is used for some maze and bypass surgeries, ICD or pacemaker insertion, heart valve repair and replacement or graft harvesting. With robotic-assisted surgery, surgeons can perform minimally invasive heart surgery by controlling surgical tools from a computer. These surgical tools are placed in robotic arms that the surgeon can control.

On the other hand, off-pump surgery does not involve a bypass machine. Instead, a surgical team member will use a device to keep the heart steady while the surgeon operates.

How Long Do Heart Bypass Grafts Last?

Please keep in mind that some patients may experience complications after CABG. One possible complication is that plaque will start blocking the new graft and may result in a heart attack. Call 911 immediately if you experience signs of a heart attack, such as chest pain or discomfort.

After heart bypass surgery, some people experience significant improvement, with bypass grafts often lasting more than ten years. However, please remember that this surgery does not cure the underlying coronary heart disease (CHD). As such, a healthy lifestyle through a balanced diet, regular exercise and managing stress can help maintain good benefits from CABG.

Continue taking any prescribed medications and work closely with your heart doctor to monitor your condition and make any necessary adjustments to your treatment plan. Your proactive efforts and regular consultations with your healthcare team are key to ensuring long-term success and well-being.

Find a Heart Doctor

Schedule a consultation with one of our doctors to learn more about your treatment options. Call 210-798-4311 to book an appointment.