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

The left internal mammary artery has a 10-year patency rate exceeding 90%, far superior to saphenous vein grafts (50–60%), making it the gold-standard conduit.

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

LIMA-to-LAD grafting is the cornerstone of CABG because the LAD supplies the largest territory and the LIMA-LAD anastomosis has the best long-term outcomes.

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

OPCAB avoids CPB by using mechanical stabilizers and heart positioners to expose coronary targets while the heart continues beating.

Question 4

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

Accepted Answer

40–50%

Answer

Saphenous vein graft attrition is significant, with approximately 40–50% of vein grafts occluded by 10 years due to intimal hyperplasia and atherosclerosis.

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

Competitive flow occurs when the native coronary is not critically stenosed, allowing antegrade native flow to compete with graft flow and potentially causing graft failure.

Cardiac Surgery Certification Exam Practice Test

Cardiac Surgery Certification Exam Practice Test

Cardiac Surgery Certification Exam Coronary Artery Bypass Grafting (CABG)