Your Coronary Artery Bypass Graft (CABG) Surgery Team
A coronary artery bypass graft (CABG) surgery requires the coordinated efforts of a team of medical professionals who will not only perform the operation and monitor your vital signs but will also prepare you before the procedure and look after your comfort and well-being when the surgery is complete.
The lead person on your team will be your cardiac or cardiothoracic surgeon, who will perform the actual CABG surgery. These surgeons specialize in treating the heart, lungs, esophagus, and chest. A cardiothoracic surgeon will have completed medical school, followed most often by a five-year residency in general surgery. After the general surgery residency, the physician will have completed a two- or three-year residency in cardiothoracic surgery. Additionally, a Board-certified cardiothoracic surgeon will have a valid license, be in good ethical standing in the profession, have passed tests demonstrating knowledge, and demonstrate lifelong learning.
The cardiac surgeon is responsible for opening the patient’s chest, choosing which blood vessel will be harvested from elsewhere in the body to use for the graft and sewing that blood vessel to the aorta and then to the heart artery after the blockage to allow blood to flow around the blockage to the heart muscle. The surgeon will wire the breastbone back together and close the incision with stitches.
Before, during, and after your procedure, your cardiac surgeon will be assisted by other care team members, including the following:
An anesthesiologist is a medical doctor trained to administer drugs that will take you "under" and block any feeling of pain or unpleasant sensations. Your anesthesiologist is involved in your care before, during, and after your surgery and may do a medical evaluation before your surgery to determine an anesthesia plan tailored for you. During surgery, the anesthesiologist oversees life support and pain control. And after the surgery, the anesthesiologist also provides pain management during recovery. If time allows before surgery, you should discuss the anesthetic plan, as well as alternatives, risks, and benefits of the chosen anesthetic techniques, with the anesthesiologist.
During the surgery, the heart is stopped while the surgeon grafts (sews) a blood vessel (a “graft”) to the clogged artery to create a bypass around a blockage. The perfusionist on the care team operates the heart-lung bypass machine. This machine takes over the responsibilities of the heart (to pump blood to the body) and the lungs (to exchange carbon dioxide in the blood for oxygen) during bypass surgery. The perfusionist may be a specially trained nurse or technician certified by the American Board of Cardiovascular Perfusion. Those who aren’t certified should have at least two years of supervised experience working in an operating room during open-heart surgeries. Some bypass surgeries called “off-pump” will occur with the heart beating and no heart-lung bypass machine.
Operating room nurses and technicians
Operating room nurses and technicians support the cardiac surgeon during the procedure. They also monitor your condition and work to make you as comfortable as possible.
An intensivist, or Intensive Care Unit (ICU) doctor, is a medical doctor who specializes in the care of critically ill patients, usually in an ICU. An intensivist may be trained in internal medicine, anesthesiology, or another medical specialty. In addition, the ICU doctor will have completed a fellowship of one or more years in critical care medicine. Depending on your hospital, you may be under the care of an intensivist while in the ICU or the cardiac surgery ICU.
Intensive care nurses
If you’ve moved into the hospital's ICU following bypass surgery, you’ll be cared for by intensive care (or critical care) nurses. These nurses have special training in caring for patients facing life-threatening problems, including cardiac and respiratory emergencies.
Cardiac care nurses
Cardiac care nurses are specially trained to work with heart disease patients and their families. They may have an additional specialty—that of critical care nurses—that prepares them to work with patients in the hospital. Otherwise, you may be visited by a cardiac care nurse in your home following bypass surgery.
Physical/occupational therapists and rehab nurses
While in the hospital and after you’re discharged, these medical professionals work with you to help build up your strength, restore function, and regain your ability to move.
Cardiac rehabilitation team
A team of healthcare professionals, including nurses, exercise physiologists, physical therapists, occupational therapists, dieticians and nutritionists, counselors, and others, will provide education and coaching to speed up your rehabilitation. During cardiac rehab, the team will support you as you learn and adopt a heart-healthy lifestyle such as eating a healthy diet, becoming physically active, and managing stress.
Cardiologist and primary care physician
Your cardiologist and primary care physician will continue to be an integral part of your care. Your cardiologist will be closely involved with your case. At the same time, you’re under the care of the cardiac surgeon and should also provide reports and updates to your primary care physician to ensure your continued coordinated care.