coronary artery bypass graft

graft (graft)

1. any tissue or organ for implantation or transplantation.

2. to implant or transplant such tissues. See also implant.

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accordion graft  a full-thickness graft in which slits have been made so that it may be stretched to cover a larger area.

arteriovenous graft  an arteriovenous fistula consisting of a venous autograft or xenograft or a synthetic tube grafted onto the artery and vein.

avascular graft  a graft of tissue in which not even transient vascularization is achieved.

Blair-Brown graft  a split-skin graft of intermediate thickness.

bone graft  a piece of bone used to take the place of a removed bone or bony defect.

cable graft  a nerve graft made up of several sections of nerve in the manner of a cable.

coronary artery bypass graft  (CABG) see under bypass.

delayed graft  a skin graft sutured back into its bed and subsequently shifted to a new recipient site.

dermal graft , dermic graft skin from which epidermis and subcutaneous fat have been removed; used instead of fascia in various plastic procedures.

fascia graft  one taken from the fascia lata or the lumbar fascia.

fascicular graft  a nerve graft in which bundles of nerve fibers are approximated and sutured separately.

full-thickness graft  a skin graft consisting of the full thickness of the skin, with little or none of the subcutaneous tissue.

heterodermic graft  a skin graft taken from a donor of another species.

heterologous graft , heteroplastic graft xenograft.

homologous graft , homoplastic graft allograft.

isogeneic graft , isologous graft, isoplastic graft syngraft.

Krause-Wolfe graft  full-thickness g.

lamellar graft  replacement of the superficial layers of an opaque cornea by a thin layer of clear cornea from a donor eye.

nerve graft  replacement of an area of defective nerve with a segment from a sound one.

omental grafts  free or attached segments of omentum used to cover suture lines following gastrointestinal or colonic surgery.

pedicle graft  see under flap.

penetrating graft  a full-thickness corneal transplant.

periosteal graft  a piece of periosteum to cover a denuded bone.

pinch graft  a piece of skin graft about 14 inch in diameter, obtained by elevating the skin with a needle and slicing it off with a knife.

sieve graft  a skin graft from which tiny circular islands of skin are removed so that a larger denuded area can be covered, the sievelike portion being placed over one area, and the individual islands over surrounding or other denuded areas.

split-skin graft  a skin graft consisting of only a portion of the skin thickness.

thick-split graft  a skin graft cut in pieces, often including about two thirds of the full thickness of the skin.

white graft  avascular g.

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coronary artery bypass graft

n. Abbr. CABG

A surgical procedure in which a section of vein or other conduit is grafted between the aorta and a coronary artery below the region of an obstruction in that artery.

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coronary artery bypass graft (CABG),

open heart surgery in which a prosthesis or a section of a vein is grafted from the aorta onto one of the coronary arteries, bypassing a narrowing or blockage in the coronary artery. The operation is performed in coronary artery disease to improve the blood supply to the heart muscle and to relieve anginal pain. Coronary arteriography pinpoints the areas of obstruction before surgery. Under general anesthesia and with the use of a cardiopulmonary bypass machine, one end of a 15- to 20-cm prosthesis or a segment of saphenous vein from the patient's leg is grafted to the ascending aorta. The other end is sutured to the clogged coronary artery at a point distal to the stoppage. The internal mammary artery may also be used as graft tissue. Usually double or triple grafts are done for multiple areas of blockage. After surgery, close observation in an intensive care unit is essential to ensure adequate ventilation and cardiac output. The systolic blood pressure is not allowed to drop significantly below the preoperative baseline, nor is it allowed to rise significantly, because hypertension can rupture a graft site. Arrhythmias are treated with medications or by electrical cardioversion. The patient is usually discharged within 5 to 8 days, unless complications occur.

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coronary artery bypass graft

CABG pron, cabbage Cardiology A procedure in which vascular grafts, usually saphenous veins–legs, rarely cephalic veins, are anastomosed end-to-side to the internal mammary arteries, bypassing atherosclerotically stenosed coronary arteries; the internal mammary artery might be a better donor, given its relative resistance to collapse; internal mammary procedures are associated with ↑ survival, better long-term patency, ↓ rate of reoperation Statistics 800,000/yr–US survive acute MI–200,000 do not; up to 350,000/yr undergo CABG,²⁄₃ of whom may benefit from the procedure Indications Pts with coronary lesions that are unsuitable for, or do not respond to, catheter-based intervention; perioperative death and MI are 4% and 10% higher, respectively, when CABG is performed urgently rather than electively; thus efforts should be made to stabilize the Pt pharmacologically before attempting revascularization; an intra-aortic balloon pump–IABP can serve as a bridge to catheterization or revascularization as long as the Pt does not have severe peripheral vascular disease, significant aortic insufficiency, or known severe aortoiliac disease, including aortic aneurysm; Pts who do not stabilize after IABP placement should be reevaluated to confirm the diagnosis of ischemic heart disease and considered for emergency catheterization Medical therapy vs CABG; it is unclear whether medical therapy–diet, exercise, and cholesterol-lowering drugs is more beneficial than surgery; medical therapy is preferred in those without evidence of myocardial ischemia, and in Pts with 1- or 2-vessel disease without significant LADS; CABG is indicated in Pts with chronic stable angina who are medical 'failures', Pts with 2-vessel disease and left anterior descending coronary artery stenosis–LADS; CABG is also indicated in 2- or 3-vessel disease; 'triple bypass' CABG is indicated for unstable angina and ischemia detected by an exercise stress test Presurgery workup EKG, stress test, echocardiography, coronary angiography Complications Progression of ASHD, recurrent angina, arrhythmia, sudden death, within 5 yrs in ± 2% of surgically treated and ± 6% of medically treated Pts Recovery ± 7-10 days. See ACME, Angina, CABG patch trial, CABRI, CASS, EAST, ERACI, GABI, RITA, Thallium imaging, Treadmill exercise test. Cf Percutaneous transluminal angioplasty, Stenting.