Overview of coronary artery disease

Your heart is the hardest working muscle you have.

The heart’s job is to keep blood circulating through the organs and tissues in your body (the heart beats more than 100,000 times a day). Like any muscle, your heart needs plenty of oxygen-rich blood to stay healthy and keep functioning.

Coronary arteries are the blood vessels that are found on your heart and carry the oxygen-rich blood to the heart muscle.

Atherosclerosis: hardening of the arteries

Every year, millions of patients are diagnosed with some form of heart disease, and one of the most common is atherosclerosis.

Atherosclerosis is commonly referred to as “hardening of the arteries”. It refers to a gradual buildup of fatty deposits within the arteries that cause the arteries to become narrowed, or even blocked.

When this process occurs in the coronary arteries, it is called coronary atherosclerosis or coronary artery disease (CAD).

Blood vessels and plaque buildup

Healthy blood vessels are strong and flexible. When fatty deposits, called plaque, develop in the lining of these arteries, several things can happen:

  • The lining of the artery becomes thicker and rougher
  • Plaque buildup narrows the opening throughout the artery
  • The narrowing makes it more difficult for blood to flow through the artery
  • The heart has to work harder to pump blood
  • The plaque can build up to a point where it completely blocks the flow of blood through the artery
  • Or, the plaque may “rupture” or break free from the artery wall causing a partial or complete blockage of the artery—this may also prevent blood from being supplied to the heart muscle

If one or more arteries become blocked, heart tissue doesn’t get the blood supply it needs to function. The results can range from mild chest pain (angina) to a severe heart attack.

Treating coronary atherosclerosis

One of the treatment options for people that are diagnosed with coronary atherosclerosis is coronary artery bypass graft (CABG) surgery, a heart surgery procedure that restores blood flow.
You should discuss treatment options with your doctor.

Understanding coronary artery bypass graft surgery

Coronary artery bypass graft surgery, or CABG (pronounced “cabbage”) , is a procedure to restore healthy blood flow to the heart. Many patients are surprised to learn that a heart bypass operation actually includes two surgical procedures.

  1. First, one or more healthy blood vessels are removed (or harvested) from the chest, leg, or forearm and will be used in creating the bypass or bypasses.
  2. Next, the surgeon creates the bypass, or detour, around the damaged or blocked artery or arteries in the heart using the harvested vessels.

With these new bypasses, the heart can then receive its much needed blood supply.

Heart with bypass

The bypass part of the surgery

When using a vessel from the forearm or leg a surgeon connects, or grafts, one end of the harvested vessel to the aorta—which supplies blood to the heart. The other end is attached to the coronary artery that has a blockage, bypassing the blocked portion of coronary artery to restore blood flow.

It is not uncommon for a surgeon to perform one or more of these grafts during an operation — Depending upon how many bypass grafts the surgeon performs, this can be referred to as double (2), triple (3), quadruple (4) or more bypasses.