Coronary Artery Bypass Grafting (CABG)

Coronary artery bypass grafting (CABG) is the most definitive revascularisation procedure for coronary artery disease, creating new conduits that bypass critically narrowed or blocked coronary arteries and restore blood flow to the heart muscle. CABG is preferred over percutaneous coronary intervention for patients with left main disease, complex multivessel disease, diabetic patients with multivessel disease, and patients with reduced left ventricular function — populations in whom trials have consistently demonstrated superior long-term survival with surgical revascularisation.

At SilverOak Health, CABG is performed using arterial grafts — the left and right internal mammary arteries and, when needed, the radial artery — because of their superior long-term patency compared to saphenous vein grafts. Total arterial revascularisation strategies using bilateral internal mammary arteries are offered to younger, lower-risk patients where the evidence for improved ten-year outcomes is compelling. Off-pump CABG (beating heart surgery without cardiopulmonary bypass) is available for selected patients, particularly those with significant aortic atherosclerosis in whom manipulation of the aorta carries higher embolic risk.

Our cardiac surgery team performs a comprehensive pre-operative assessment including echocardiography, coronary anatomy review, and anaesthetic risk stratification. Enhanced recovery protocols minimise sedation, facilitate early extubation, and enable most patients to be discharged from the intensive care unit within 24 hours. Cardiac rehabilitation — a structured supervised exercise and education programme commencing within four to six weeks of surgery — significantly improves long-term outcomes and is encouraged for all CABG patients. Graft patency at ten years exceeds 90% for internal mammary artery grafts, ensuring durable, long-lasting coronary revascularisation.