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Total Arterial Bypass (CABG)
Reviewed by Dr. Ajay Kaul, M.Ch — Chairman, Cardiac Sciences, Fortis Noida · Updated August 2026
The 60-second summary
What it is
A bypass operation that uses only arterial grafts — vessels from the chest and forearm — instead of the traditional leg vein, to create new routes around blocked heart arteries.
Who needs it
Patients needing bypass surgery whose artery anatomy is suitable for harvesting multiple arterial grafts — generally where long-term graft durability matters most, including younger patients and those with diabetes.
Hospital stay
Usually 5–8 days — similar to standard bypass, sometimes slightly longer given the additional graft harvesting involved.
Back to normal
Most people return to desk work in 4–6 weeks; full recovery in about 3 months — comparable to standard bypass surgery.
Are you a candidate for total arterial bypass?
- Multiple coronary artery blockages needing bypass, in a patient with suitable arterial graft anatomy
- Younger patients, where long-term graft durability meaningfully affects the number of future procedures needed
- Diabetes, where arterial grafts have shown particular advantage over vein grafts in durability
- Adequate arterial supply available for harvest, internal mammary and radial, without compromising blood flow to the arm or chest wall
Total arterial grafting isn't automatic for every bypass patient.
Total arterial grafting isn't automatically the right choice for every bypass patient — it depends on your specific artery anatomy, the number of grafts needed, and your overall risk profile. Dr. Kaul will assess honestly whether you're a genuine candidate, rather than defaulting to it for every case.
How Dr. Kaul performs total arterial bypass
1 · Every graft an artery, not a vein
Using the internal mammary arteries from the chest and the radial artery from the forearm for every graft needed, rather than mixing in the traditional leg vein.
2 · Why the artery matters
Arterial grafts have thicker, more muscular walls that resist narrowing over time far better than vein grafts — evidence links this to meaningfully better graft survival at 10–15 years and beyond.
3 · A technique that demands more, by design
Total arterial grafting is technically more demanding and takes longer than conventional bypass with vein grafts, which is why it isn't offered by every surgical team as standard.
“Total arterial bypass: why the graft choice matters as much as the surgery” — video launching soon on our YouTube channel
Recovery, week by week
The risks, honestly
Total arterial bypass carries the same general risks as standard bypass surgery — bleeding, infection, irregular rhythm, stroke — plus considerations specific to harvesting arterial grafts, including a small risk of reduced blood flow sensation in the forearm where the radial artery is taken. This is rare, and screened for beforehand with a simple test. Dr. Kaul will discuss your individual risk, including whether your arm circulation is suitable for radial artery harvest, before the operation.
What total arterial bypass costs
Every case is priced individually
Delhi NCR private hospitals (indicative) — typically similar to or slightly above standard bypass surgery, reflecting the additional graft harvesting and longer operative time.
Common questions
Evidence points to better long-term durability for arterial grafts, particularly beyond 10 years. It's technically more demanding, which is part of why it isn't universal practice — but for suitable patients, it's often the stronger long-term choice.
Diagnosed with blockages? Talk before you decide.
A conversation costs nothing — and it may change the plan.