Coronary artery bypass graft (CABG) is a surgical procedure in which a vessel, normally the left internal mammary artery and/or a segment of an excised vein (typically from the leg), is grafted to the coronary arteries to bypass a blockage. CABG has been shown to be superior to percutaneous coronary intervention for patients with complex three vessel disease and left main coronary artery disease. All patients undergoing CABG should receive aspirin preoperatively; they also should receive a beta blocker preoperatively to reduce the likelihood of postsurgical atrial fibrillation. All patients should receive aspirin within 6 hours postsurgery to prevent graft thrombosis and should continue taking aspirin indefinitely, be started or continued on a high-intensity statin, be enrolled in a cardiac rehabilitation program, and be screened and treated if necessary for depression.
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