Is coronary artery bypass surgery risky?

Coronary artery bypass grafting (CABG) is now a highly mature surgical procedure. It is widely accepted internationally, and over the past ten to twenty years, acceptance of this surgery has steadily increased in China as well. The procedure itself is well-established—both technically and in terms of complication risk—and is considered routine.

Approximately tens of thousands of patients undergo CABG annually in China, with even higher numbers reported internationally.

Like any surgical intervention, CABG carries inherent risks. As the heart is the most vital organ in the body, the associated surgical risks depend on several factors:

First, timing of surgery—specifically, how early or late the disease is diagnosed. Delayed diagnosis may lead to irreversible damage, thereby increasing surgical risk.

Second, the patient’s overall health status. For example, long-standing diabetes or impaired renal function significantly elevates risk. Patients requiring dialysis already have severely compromised kidney function. Moreover, since CABG is commonly performed in elderly patients with coronary artery disease, age-related decline in organ function further increases perioperative risk.

In clinical practice, many high-risk patients—including those with multiple comorbidities and even nonagenarians—undergo CABG successfully, particularly when off-pump (beating-heart) techniques are employed. This approach enhances patient safety. Globally, the overall operative mortality rate for CABG is approximately 1–2%, making it a relatively safe surgical procedure.