CABG (coronary artery bypass graft) - Risks of surgery

As with all types of surgery, a coronary artery bypass graft (CABG) carries risks of complications.

Some of the main complications associated with a CABG are described below.

Irregular heartbeat

Up to one in every three people who have a CABG will develop a problem called atrial fibrillation. This is a condition that causes an irregular and often abnormally fast heart rate.

However, this is not usually serious and can normally be treated easily with a course of medication.

Infection

There is a chance that the wounds in your chest and arm or leg (depending on where the grafted blood vessels were removed) could become infected after a CABG. This is estimated to occur in up to one in every 25 people who have the procedure.

There is also a smaller chance of more serious infections affecting the lungs or inside of the chest after a CABG.

Most infections that do develop after a CABG can usually be treated successfully with antibiotic tablets or injections.

Reduced kidney function

Less than one in every 20 people who have a CABG will experience reduced kidney function after surgery. In most cases, this is only temporary and the kidneys begin working normally after a few days or weeks.

In rare cases, you may need to have temporary dialysis until your kidneys recover. This involves being attached to a machine that replicates the functions of the kidneys.

Problems affecting the brain

Up to one in every 20 people experience some problems with their memory after a CABG and also find it difficult to concentrate on things like reading a book or newspaper. This will usually improve in the months following the operation, but it can sometimes be permanent.

There is also a risk of serious problems affecting the brain during or after a CABG, such as a stroke. It's estimated that around one in every 50 people who has a CABG will experience a stroke, which can leave you with permanent movement, speaking and swallowing problems and can be fatal in some cases.

Heart attacks

Both the heart and the coronary arteries that supply the heart with blood are in a vulnerable state after surgery, especially in the first 30 days after a CABG.

Around one in every 15-50 people who have a CABG are estimated to have a heart attack during surgery, or shortly afterwards. Heart attacks are the leading cause of death after a CABG.

Who's most at risk?

There are several factors that increase your risk of developing complications, including:

• Your age – Your risk of developing complications after surgery increases as you get older.
• Having another serious long-term health condition – Having a condition such as diabetes, chronic obstructive pulmonary disease or severe chronic kidney disease can increase your risk of complications.
• Being a woman – Women tend to develop coronary artery disease later than men. It is thought that this may lead to a higher risk of experiencing complications because they are generally older at the time of surgery.
• Having emergency surgery to treat a heart attack – Emergency surgery is always riskier as there is less time to plan the surgery, and the heart can be seriously damaged from the heart attack.
• Having three or more vessels grafted – The more complex the operation, the greater the chance that complications will occur.
• Being obese – If you are obese the surgeon will have to make a deeper incision to gain access to your heart, and deeper incisions carry a higher risk of becoming infected.

Your surgical team will be able to provide you with more detailed information about your specific risk before surgery takes place.