Sometimes patients need to have open heart surgery when they have blocked coronary arteries of the heart. Patients may need to have a standard coronary artery bypass graft (CABG) or the newer multi-vessel off-pump CABG procedure done. The off-pump CABG (OPCABG) has advantages in that the heart is not placed on bypass and the risk of stroke and bleeding is reduced. Recovery also seems to be better with the newer method. In both CABG procedures, the blocked artery is bypassed to create a path for blood flow to the heart muscle. A piece of the saphenous vein is used as a graft but doctors do also now use the left internal mammary artery (LIMA), right internal mammary artery(RIMA) and the radial artery (RA) as grafts.