Coronary artery bypass, also called coronary artery bypass graft, surgical treatment for coronary heart disease (or coronary artery disease), usually caused by atherosclerosis. In atherosclerosis, fatty plaques build up on the walls of the coronary arteries, gradually diminishing the flow of blood through them. Insufficient blood flow through the coronary arteries into the heart musculature can manifest as angina pectoris (pain or discomfort in the chest) and increases the risk of myocardial infarction (heart attack).
The coronary artery bypass entails transplanting one or more veins to create new paths for arterial blood to flow from the aorta through the coronary arteries, circumventing the obstructed sections of the arteries. The grafts are usually saphenous veins taken from one or both of the patient’s legs, though in the case of double bypass surgery one of the internal mammary arteries, which supply blood to the chest wall, can be diverted to supply the heart muscle. In some instances a vein from the wrist may be used.
Coronary artery bypass surgery became widely used after its safety and effectiveness in relieving angina were demonstrated in the late 1960s. The procedure often requires open-heart surgery; however, medical advances made possible the use of minimally invasive alternatives such as keyhole surgery, which involves only a relatively small incision in the chest.