What are the risks of coronary artery bypass grafting (CABG)?

Coronary artery bypass grafting (CABG) carries several risks, including bleeding and infection, arrhythmias, impaired cardiac function, neurological complications, and organ dysfunction. As a major cardiothoracic surgical procedure, CABG is associated with various potential postoperative emergencies. Patients experiencing persistent chest tightness or chest pain, altered mental status, or persistent high fever should seek immediate medical evaluation and treatment.

1. Bleeding and infection risk: Due to the extensive surgical incision, oozing from the wound site commonly occurs during and after surgery. Inadequate hemostasis may lead to hemothorax. Postoperatively, the surgical wound and pleural cavity are susceptible to bacterial colonization, potentially causing localized inflammation, fever, and wound erythema and swelling.

2. Arrhythmia risk: Surgical manipulation may irritate cardiac tissue and disrupt the heart’s intrinsic rhythm. The heart remains particularly vulnerable in the early postoperative period; electrolyte imbalances and physical fatigue can trigger arrhythmias, impairing normal cardiac pumping function and disrupting systemic circulation.

3. Impaired cardiac function risk: Some patients experience fluctuations in myocardial perfusion postoperatively, potentially resulting in myocardial injury. Reduced myocardial contractility and diastolic function may manifest as chest tightness, shortness of breath, and decreased exercise tolerance. In severe cases, systemic circulation may be compromised, delaying overall recovery.

4. Neurological complications risk: Hemodynamic changes during surgery may facilitate the formation and embolization of microthrombi into cerebral vessels. This may cause transient or sustained cerebral hypoperfusion, leading to dizziness or excessive drowsiness; in severe cases, it may result in neurological deficits affecting consciousness and motor function.

5. Organ dysfunction risk: Surgical trauma and cardiopulmonary bypass place additional stress on hepatic and renal function, impairing normal metabolic processes. The heightened postoperative systemic stress response increases functional demands across multiple organs, predisposing patients to transient organ dysfunction and prolonging the recovery period.

Postoperatively, patients should gradually initiate structured rehabilitation exercises and adhere to a low-fat, low-sodium, light diet. Maintaining emotional stability and regular sleep patterns, strictly following prescribed medication regimens, and undergoing scheduled follow-up assessments of cardiopulmonary and organ function are essential for consolidating surgical outcomes and optimizing long-term recovery.