Cardiac Surgery Certification Exam Coronary Artery Bypass Grafting (CABG)

Question 1

The internal mammary artery (IMA) is preferred for coronary bypass grafting because:

Accepted Answer

It has superior long-term patency compared to saphenous vein grafts

Answer

It is easier to harvest

Answer

It has greater diameter matching all coronary targets

Answer

It requires less anticoagulation

Question 2

The most common coronary artery target for the left internal mammary artery (LIMA) graft in CABG is:

Accepted Answer

Left anterior descending (LAD) artery

Answer

Right coronary artery (RCA)

Answer

Obtuse marginal (OM) artery

Answer

Posterior descending artery (PDA)

Question 3

Off-pump CABG (OPCAB) differs from conventional CABG primarily in that:

Accepted Answer

The procedure is performed on a beating heart without cardiopulmonary bypass

Answer

The aorta is not cross-clamped

Answer

Only venous conduits are used

Answer

TEE monitoring is not required

Question 4

The saphenous vein graft failure rate at 10 years is approximately:

Accepted Answer

40–50%

Answer

5–10%

Answer

80–90%

Answer

Less than 5%

Question 5

Competitive flow in a coronary bypass graft occurs when:

Accepted Answer

A native coronary with moderate stenosis provides sufficient native flow to outcompete the graft

Answer

The bypass graft flow is greater than native coronary flow

Answer

Two grafts are placed to the same coronary territory

Answer

The graft is kinked near the anastomosis

Question 6

Which intraoperative finding most commonly prompts conversion from off-pump to on-pump CABG?

Accepted Answer

Hemodynamic instability during cardiac displacement

Answer

Inadequate conduit length

Answer

Anesthesia failure

Answer

Absence of epicardial fat