LIMA to LAD is performed in the operating theatre and other lesions are treated with PCI, either at the operating room, right after the anastomosis or serval days later. After the procedure
After the procedure, the patient is usually transferred to the intensive care unit, where they are extubated if it hasnt been done already in the operating theatre. The following day they exit the ICU, and 4 days later, if no complications occur, the patient is discharged from the hospital.A series of drugs are commonly used in the early postoperative period. Dobutamine, a beta agent, can be used to increase the cardiac output that sometimes occurs some hours after the operation. Beta blockers are used to prevent atrial fibrillation and other supraventricular arrhythmias. Biatrial pacing through the pacing wires inserted at operation might help towards preventing atrial fibrillation. Aspirin 80mg is used to prevent graft failure. Angiotensin-converting enzyme (ACE) inhibitors and Angiotensin receptor blockers (ARBs) are used to control blood pressure, especially in patients with low cardiac function (<40%). Amlodipine, a calcium channel blocker, is used for patients that radial artery was used as a graft.After the discharge, patients might suffer from insomnia, low appetite, decreased sex drive, and memory problems. This effect is usually transient and lasts 6 to 8 weeks. A tailored exercise plan usually benefits the patient. Results
CABG is the best procedure to reduce mortality from severe CAD and improve quality of life. Operative mortality relates strongly to age of patient.
Left radial artery and left Gastroepiploic artery can be used as well. Long term patency is influenced by the type of artery used, as well as intrinsic factors of the cardiac arterial circulation.Venous grafts used are mostly great saphenous veins and in some cases lesser saphenous vein. Their patency rate is lower than arteries. Aspirin protects grafts from occlusion; adding clopidogrel does not improve rates. CABG vs PCI
CABG and percutaneous coronary intervention (PCI) are the two modalities the medical community has to revascularize stenotic lesions of the cardiac arteries. Which one is preferable for each patient is still a matter of debate, but it is clear that in the presence of complex lesions,  significant Left Main Disease and in diabetic patients, CABG seems to offer better results to patients than PCI. Strong indications for CABG also include symptomatic patients and in cases where LV function is impaired. History
Pre-CABG
Surgical interventions aiming relieve angina and prevent death in the early 20th century, were either sympatheticectomy (a cut on the sympathetic chain that supplies the heart, with  disappointing and inconsistent results) or pericardial abrasion (with the hope that adhesions would create significant collateral circulation).French Surgeon Alexis Carrel was the first to anastomose a vessel (a branch of carotid artery) to a native artery in the Heart, in a canine model- but because of technical difficulties the operation could not be reproduced. In mid 20th century, revascularization efforts continued.