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Updated: Jun 23, 2026

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery

Published on: March 27, 2018

Assessing the environmental impact of coronary artery bypass grafting to decrease its footprint.

Egid M van Bree^1,2, Tim Stobernack¹, Tadzjo Boom¹

¹Department of Intensive Care Medicine, Radboudumc, Nijmegen, Netherlands.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery

|February 17, 2025

Summary

Reducing disposable products and optimizing energy use in operating rooms can significantly lower the environmental impact of coronary artery bypass grafting (CABG) surgery. This study identifies key areas for sustainable healthcare transitions in cardiac procedures.

Keywords:

Carbon footprint Cardiac surgery Greenhouse gases Life cycle assessment Sustainable healthcare

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Area of Science:

Environmental Science
Healthcare Sustainability
Life Cycle Assessment

Background:

Healthcare systems face increasing pressure to adopt environmentally sustainable practices.
Coronary artery bypass grafting (CABG) is a common surgical procedure with a notable environmental footprint.
Urgent need for mitigation strategies in cardiac surgery trajectories.

Purpose of the Study:

To identify key areas for environmental impact mitigation in coronary artery bypass grafting (CABG) patient trajectories.
Quantify the environmental burden associated with a standard CABG procedure.
Provide data-driven recommendations for sustainable healthcare in cardiac surgery.

Main Methods:

Conducted a standardized life cycle assessment (LCA) following ISO14040/44 guidelines.
Analyzed an individual patient trajectory from operating room admission to intensive care unit discharge.
Collected data on products, processes, and services from a Dutch academic hospital for 12 patients, using the ReCiPe 2016 method for impact calculation.

Main Results:

A single CABG trajectory generated 414 kgCO2 equivalents, equivalent to 2753 km of driving.
Major environmental impacts included global warming, particulate matter, toxicity, land use, and acidification.
Top contributors to global warming were disposable operating room products (162 kgCO2eq), energy consumption (48 kgCO2eq), and staff commute (36 kgCO2eq).

Conclusions:

Global warming is the primary environmental concern for CABG trajectories.
Reducing or replacing disposable surgical products with reusables offers significant mitigation potential.
Optimizing operating room energy systems, transitioning to renewable energy, and promoting low-emission commutes are crucial for further impact reduction.