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Page: Terminology
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There are many variations on terminology, in which one or more of 'artery', 'bypass' or 'graft' is left out. The most frequently used acronym for this type of surgery is CABG (pronounced 'cabbage'), pluralized as CABG's (pronounced 'cabbages'). More recently the term aortocoronary bypass (ACB) has come into popular use. CAGS (Coronary Artery Graft Surgery, pronounced phonetically) has been used (primarily outside the United States) and should not be confused with Coronary Angiography (CAG).
Number of bypasses
The terms single bypass, double bypass, triple bypass, quadruple bypass and quintuple bypass refer to the number of coronary arteries bypassed in the procedure. In other words, a double bypass means two coronary arteries are bypassed (e.g. the left anterior descending (LAD) coronary artery and right coronary artery (RCA)); a triple bypass means three vessels are bypassed (e.g. LAD, RCA, left circumflex artery (LCX)); a quadruple bypass means four vessels are bypassed (e.g. LAD, RCA, LCX, first diagnonal artery of the LAD) while quintuple means five. Less commonly more than four coronary arteries may be bypassed.
A greater number of bypasses does not imply a person is "sicker," nor does a lesser number imply a person is "healthier." A person with a large amount of coronary artery disease (CAD) may receive fewer bypass grafts due to the lack of suitable "target" vessels. A coronary artery may be unsuitable for bypass grafting it if it is small (< 1 mm or < 1.5 mm depending on surgeon preference), heavily calcified (meaning the artery does not have a section free of CAD) or intramyocardial (the coronary artery is located within the heart muscle rather than on the surface of the heart). Similarly, a person with a single stenosis ("narrowing") of the left main coronary artery requires only two bypasses (to the LAD and the LCX). However, a left main lesion places a person at the highest risk for death from a cardiac cause.
The surgeon reviews the coronary angiogram prior to surgery and identifies the lesions (or "blockages") in the coronary arteries. The surgeon will estimate of the number of bypass grafts prior to surgery, but the final decision is made in the operating room upon examination of the heart.
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Important notice:
The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other
qualified health provider with any questions you may have regarding a medical condition.
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