The types of Coronary Artery Bypass Grafts (CABG) depend on several factors. For scheduled CABG operations, a pre-admission assessment is performed traditionally in order to identify your current physical condition. This involves a physical examination and may include other tests like x-rays, electrocardiograms (ECG), and blood tests.
All this is done in order to decide what type of bypass graft is best for you. Which, ultimately, depends on the location and extent of the occlusion, the size of your coronary arteries, the availability of healthy arteries and veins for the graft, and finally, your current medical condition.
What Type of CABG Do You Need?
Before we can look into the different types of Coronary Artery Bypass Grafts, let’s talk about why you may need a specific type over the other. As mentioned, tests are performed in order to examine the current condition of Coronary Artery Disease. These tests will play a large role in deciding what type of CABG surgery you need.
Other factors considered will include your symptoms, lifestyle, the current functions of your heart (and its structure), your age, and other medical conditions.
As a palliative treatment, CABG is performed in order to relieve the symptoms of your condition. So, if done correctly, you should be able to live your life normally. It’s not a cure-all, and about 94% of people who get the surgery done will require a repeat intervention. But, for the next 10-20 years, CABG should lower any risk of a heart attack or stroke.
The first type of Coronary Artery Bypass Grafts is arterial grafts. These are the most common as arterial grafts are considered to be far more durable than vein grants (which means that its potential for long-term disease prevention is far higher.)
However, according to this critical journal of the comparison between the two types, the benefits of arterial grafts over vein grafts have not been studied enough for that to be concluded at this time. What we do know for sure about arterial grafts, are the following:
- Internal Thoracic Arteries: These are the most common type of bypass grafts used and has become the standard for the operation. They’ve been associated with the best long-term results
- Radial (Arm) Artery: This is another common type of graft and it is used because it is the one least associated with any side-effects or complications, especially when the required medication (calcium channel blocker) is taken to prevent any calcification.
Vein grafts are already largely considered to be inferior, at least, when compared to arterial grafts as they are known to fail quite quickly in the long-term — requiring a repeat intervention. However, the use of veins is known to be far less invasive (and thus far safer during the actual surgery.)
For example, with saphenous veins (one of the most common types of veins used — which are found in your lower extremities), instead of a traditionally long incision, which poses a heavy risk for infection, removal for veins will only require small incisions that recover much faster than when traditional arterial grafts are used.
Conclusion: Types of Coronary Artery Bypass Grafts
The type of Coronary Artery Bypass Graft that is best for you will depend quite heavily on what your body needs and what your doctor and cardiologist believe it can handle. There are obvious benefits and downsides to both, and the consideration required for either or will depend solely on your unique situation.
- Rihal, Charanjit S., et al. “Indications for Coronary Artery Bypass Surgery and Percutaneous Coronary Intervention in Chronic Stable Angina.” Circulation, vol. 108, no. 20, 2003, pp. 2439–2445., doi:10.1161/01.cir.0000094405.21583.7c.
- Gaudino, Mario, et al. “Arterial Grafts for Coronary Bypass.” Circulation, vol. 140, no. 15, Aug. 2019, pp. 1273–1284., doi:10.1161/circulationaha.119.041096.