A team of surgeons, nurses, and other medical staff will participate
coronary artery bypass graft (CABG) surgery. Each team
member has a specific set of responsibilities before, during, and after the
CABG surgery is a complex operation that involves a great deal of
technical expertise and precision. The medical professionals in the operating
room during your surgery will be specially trained in performing the CABG
procedure. Also, your medical team will probably have worked together as
a team many times in the past.
You might have a team that helps you decide whether to have bypass surgery. This team could be your cardiac surgeon and another cardiologist, called an interventional cardiologist, who does angioplasty procedures. They can help you understand your treatment options and help you make a decision.
Though the exact composition will differ at particular hospitals, the
medical team that performs a CABG surgery is roughly similar at all
Surgical team: Your cardiac surgeon or surgeons
and a surgical assistant will perform your CABG
Specially trained nurses will assist the surgical
Perfusionist: A certified medical technician monitors the
heart-lung bypass machine.
You will likely first meet your cardiac surgeon at his or her office
where you will discuss specific aspects of your CABG surgery. Many hospitals
require that two cardiac surgeons perform this kind of surgery. Cardiac
surgeons lead the procedure and are responsible for performing its most
intricate parts. Specifically, your surgeon will handle your heart and blood
vessels, graft the new blood vessels to your coronary arteries, and oversee all
the other parts of the surgery.
All surgeries also have a surgical assistant, who is typically
responsible for harvesting the blood vessels that will be used as graft
material as well as assisting the surgeon with opening and closing your chest
and sewing (suturing) your incision after surgery. The surgical assistant is
also the individual who will most regularly check on your progress as you
You will probably meet one or more members of your anesthesia team
the evening before and the day of your surgery.
Your anesthesia team will give you the proper dose of general
anesthesia so that you are unconscious during the operation.
Also, the team will monitor your vital signs and correct any
changes in your blood pressure, heart rhythm, or blood oxygen levels with
adjustments to the anesthesia and medicines you are receiving.
This team will keep you comfortable during the procedure by treating
any pain associated with your CABG surgery. The team will give you medicines
through a tube inserted into a vein (intravenous, or IV).
Your anesthesia team is also responsible for making sure that you
receive enough medicine to control your pain after your surgery.
In the hours that follow surgery, a
respiratory therapist will work with the anesthesia
team and your surgeon to monitor your breathing to make sure that you continue
to receive enough oxygen through your ventilator. Your respiratory therapist
will also help you come off the ventilator as soon as possible.
The nursing team is made up of several nurses with special training
in CABG surgery. The nurses prepare you for the surgery and assist the
anesthesia team in your care during the procedure. Also, they ensure that
appropriate instruments are available and assist the surgeon with the handling
of the instruments.
The perfusionist, a certified medical technician responsible for
monitoring the heart-lung bypass machine, makes sure that the machine is
correctly doing the jobs of your heart and lungs during your CABG
Gray RJ, Sethna DH (2012). Medical management of the patient undergoing cardiac surgery. In RO Bonow et al., eds., Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 2, pp. 1793–1810. Philadelphia: Saunders.
Hillis LD, et al. 2011 ACCF/AHA Guideline for coronary artery bypass graft surgery: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 124(23): e652–e735.
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
How this information was developed to help you make better health decisions.