Coronary artery bypass grafting (CABG) involves replacing a segment of the coronary artery compromised by an atherosclerotic lesion with a graft of a vessel (vein or artery) that bypasses the obstruction. This procedure is indicated to relieve angina symptoms when they are resistant to medical therapy and is superior to medical treatment in prolonging survival in patients with advanced coronary artery disease: patients with significant stenosis of the left coronary artery immediately after its origin or with stenosis of three coronary branches (or two vessels, including the proximal segment of the left anterior descending artery) along with reduced left ventricular function.
Furthermore, CABG is preferable to PTCA in most patients with extensive coronary artery disease.
The number of bypass grafts that can be performed depends on the number of coronary arteries or coronary branches obstructed. Potential risks are essentially determined by factors related to the patient’s general health. It is estimated that for a patient with preserved left ventricular function, in good general condition, and without serious illness, the risk of death is around 2%.
The Ministry of Health Decree No. 70 of April 2, 2015, on hospital care standards for isolated coronary artery bypass grafting (CABG) procedures, establishes a maximum mortality threshold adjusted for severity of 4%.
The following indicator was calculated:
1) Mortality 30 days after coronary artery bypass grafting (CABG):
The short-term outcome of CABG can be a good indicator of the quality of cardiac surgery facilities. The assessment refers to the entire hospital and post-hospital care process (30 days after surgery) and concerns isolated CABG, i.e., not associated with valve surgery or endarterectomy. The choice to consider isolated interventions is linked to the fact that both the mortality rate and the risk factors are different for combined interventions.
The value of the indicator may vary between regional areas and facilities; this phenomenon, in addition to the different quality of care, may be caused by the heterogeneous distribution, due to the case mix, of various risk factors such as age, gender, and patient health conditions.
Following tests for associations between outcome trends and new clinical variables introduced into the SDO framework starting in 2018, the following indicator was also defined:
2) “30-day mortality after coronary artery bypass grafting (CABG) – with new variables”: the outcome is calculated from the date of admission for CABG, and the exposure is given by the hospital to which the patient was admitted.
This indicator maintains the structure and calculation methods previously described, adding variables related to ejection fraction and serum creatinine concentration measured at admission as predictive factors in the outcome rate adjustment model.
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Indicators 
