Heart Bypass Surgery

Heart bypass surgery is also known as coronary bypass surgery. The goal of this surgery is to replace damaged arteries in your heart with blood vessels from another area of your body.

This surgery is used when your coronary arteries are blocked or damaged. The coronary arteries supply the heart’s muscles with oxygenated blood. They are very important to your health. If they are blocked or the flow of blood is restricted, your heart cannot function properly. This can lead to heart failure.

Heart bypass surgery may be planned or done as emergency surgery. Emergency bypass may be performed if you are admitted for a severe heart attack or other coronary event.

When plaque—a material in the blood—builds up on the walls of arteries, blood flow to the heart muscle is reduced. Since the heart is not receiving adequate blood, the muscle is more likely to tire and fail. This type of damage most often affects the left ventricle, reducing its pumping strength. The left ventricle is the heart’s primary pump (Mayo Clinic).

You will need heart bypass surgery if your coronary arteries become so narrowed or blocked that you run a high risk of a fatal heart attack. This condition is called coronary artery disease. It is also called atherosclerosis. Bypass is performed when the blockage is too severe to be managed with medication or other treatment.

Heart bypass surgery can treat coronary heart disease and lower your risk of a heart attack. However, you will still have a high risk of coronary events. Even after surgery, lifestyle changes will be necessary. You will have to eat a healthy diet and get regular exercise. You may also need to take medication to manage any underlying conditions.

Heart bypass surgery is open-heart surgery. This is major surgery, and there are significant risks.

Complications that could arise from heart bypass surgery include:

• arrhythmia (irregular heart beat, which is rare)
• bleeding
• blood clots
• chest pain
• heart attack due to blood clots
• infection of the wound
• kidney failure
• low-grade fever
• memory problems (which may fade in time)
• stroke

Prior to the surgery, your doctor will do a comprehensive examination. The goal is to reduce your risk of surgical complications. Some medical conditions can complicate surgery. It is important to inform your doctor—or emergency room team—if you have:

• diabetes
• emphysema
• kidney disease
• peripheral artery disease

In general, outcomes are better for planned surgery than emergency surgery.

Your doctor will give you complete instructions on how to prepare for heart bypass surgery. During pre-operative appointments, your doctor and team will ask numerous questions about your health. Be prepared with a list of all medications you are taking, including over-the-counter drugs and supplements. You should also be able to tell your doctor about any prior surgeries. It’s vital that you answer these questions as honestly and completely as possible.

You’ll also undergo several tests. These tests will help your doctor get an accurate picture of your overall health. Tests include:

• blood samples
• chest X-ray
• electrocardiogram, to test heart function
• angiogram, to look at artery health

Some ways your doctor may have you prepare for surgery include:

• Stopping any medication that affects how your blood clots. Many pain relievers and heart medications affect clotting. However, you should not stop these drugs on your own. ONLY stop medication if your doctor tells you to do so.
• Quitting smoking. It is bad for your heart and increases healing time.
• Contacting your doctor if you experience symptoms of a cold or flu. Heart infections can become very serious.
• Preparing your home and making arrangements for your weeklong hospital stay.
• Washing your body with a special soap the day before the procedure. This reduces the risk of infection.
• Fasting, including not drinking water, beginning at midnight before your surgery
• Taking any and all medications your doctor gives you.
• Following your doctor’s instructions
• Showing up to the hospital on time.

Before the Surgery

Prior to surgery, you’ll change into a hospital gown and be given an IV. Through this IV, your team will be able give you medication, fluids, and anesthesia. When the anesthesia begins working, you’ll fall into a deep, painless sleep. When you wake, the surgery will be complete and you’ll be in an intensive care unit. You’ll also be hooked up to a breathing machine. There will be a tube in your mouth.

While you’re sleeping, you’ll be wheeled to an operating room. The surgery will take three to six hours. During that time, your doctor may repair two to four coronary arteries.

The Surgery

To begin, your surgeon will make an incision in the middle of your chest. Your ribcage will be spread apart to expose your heart. Alternatively, your surgeon may opt for minimally invasive surgery. This involves smaller cuts and specialized, miniaturized instruments.

You will be hooked up to a heart-lung machine. It will circulate oxygenated blood through your body while your surgeon operates on your heart. Some procedures may be performed “off pump” meaning connecting you to the heart-lung machine may not be necessary.

Your doctor will remove a healthy blood vessel from inside your chest wall or leg. This will be implanted to replace the blocked or damaged artery.

When your surgeon is done, the heart-lung machine will be removed. The function of the bypass will be checked. Once it is working properly, you’ll be stitched up, bandaged, and taken to the intensive care unit for monitoring.

When you wake up from heart bypass surgery, there will be a tube in your mouth. Try not to feel frightened. You may also feel pain or have side effects from the procedure, including:

• short-term memory loss
• confusion
• trouble keeping track of time

You can expect to be in the intensive care unit for one or two days. There, your vital signs will be closely monitored. Once you are stable, you will be moved to another room. You can expect to stay in the hospital for up to a week.

Before you leave the hospital, your medical team will give you complete instructions on how to care for yourself. These could include:

• caring for the incision wound(s)
• getting plenty of rest
• refraining from physical activity

Even without any complications, recovery from heart bypass surgery can take between six and 12 weeks. Notify your doctor of any lasting pain or discomfort during your follow-up appointments. You should also call your doctor if you have:

• fever over 100.4 F
• increasing pain in your chest
• rapid heart rate
• redness or discharge around the incision

A bypass can fix a blocked artery, but you may need to change some habits to prevent future heart disease. Talk to your doctor about dietary and other lifestyle changes to follow after surgery.