What Is Heart Bypass Surgery?
Heart bypass surgery, also known as coronary artery bypass
surgery, aims to replace damaged arteries in the heart. A surgeon uses blood
vessels from another area of the body to repair the damaged arteries.
This surgery is used when the coronary arteries become blocked or
damaged. The coronary arteries supply the heart’s muscles with oxygenated
blood. If they are blocked or the flow of blood is restricted, the heart can’t
function properly. This can lead to heart failure. According to the Centers for Disease Control (CDC),
doctors perform 395,000 such surgeries in the United States each year.
Why You May Need Heart Bypass Surgery
When plaque, which is a material in the blood, builds up on
the walls of the arteries, there’s less blood flow to the heart muscle. 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, the heart’s
Doctors recommend 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, or atherosclerosis.
Bypass surgery is performed when the blockage is too severe to be managed with
medication or other treatment.
How Is the Need for Bypass Surgery Determined?
Prior to the surgery, a team of physicians, along with a
cardiologist, will identify whether or not you can safely undergo open-heart
surgery. Some medical conditions can complicate surgery or eliminate it as a
Conditions that can cause complications include:
Tell your doctor about these issues along with family history,
prescription and over-the-counter medications before any surgery is scheduled.
In general, outcomes are better for planned surgery than emergency surgery.
What Are the Risks of Heart Bypass Surgery?
As with any “open heart” surgery, heart bypass surgery does carry
significant risks. However, recent technology advancements have helped improve
the procedure, making the likelihood of success much higher.
There are some possible complications that can arise after
- blood clots
- chest pain
or permanent memory loss
- heart attack or stroke
Alternatives to Heart Bypass Surgery
In the past decade, an increasing number of alternatives to heart
bypass surgery have become available.
Balloon angioplasty is the most common
doctor-recommended alternative to heart bypass surgery. During this treatment,
a tube is threaded through the clogged artery, and a small balloon is inflated
to widen the artery. The doctor then removes the tube and the balloon. In most
cases, they leave behind a small metal scaffold called a stent that will keep
the artery from contracting back to its original size. According to the
American Heart Association, balloon angioplasty is not as effective as heart
bypass surgery, but it's far less risky.
Enhanced External Counterpulsation (EECP)
EECP was approved by the Food and Drug Administration in 2003 as
an alternative to heart bypass surgery, and some studies are very positive about its
effectiveness. It’s an outpatient treatment that is administered
daily for a period of one to two hours each day over the course of seven weeks.
EECP involves compressing blood vessels in the lower limbs to
increase blood flow to the heart. Through this compression technique, extra
blood flow is delivered to the heart with every heartbeat. Over time, some
blood vessels may develop extra “branches” that will deliver blood to the
heart, a sort of “natural bypass.”
There are some medications you may consider trying before
resorting to heart bypass surgery or any of the other above methods. So-called
“beta blocker” drugs can relieve stable angina. Cholesterol-reducing drugs can
slow the buildup of plaque in arteries. Most doctors agree that a daily dose of
“baby” (low-dose) aspirin can go a long way to prevent heart attacks in
Diet and Lifestyle Changes
Of course, the ultimate preventative measure is a “heart-healthy”
lifestyle, as prescribed by the American
Heart Association. A diet high in omega-3 fatty acids that avoids saturated
and trans fats will enable the heart to best serve the body.
How to Prepare for Heart Bypass Surgery
If your doctor recommends heart bypass surgery, they’ll give you
complete instructions on how to prepare. If the surgery is scheduled in advance
and not an emergency procedure, you’ll most likely have several pre-operative
appointments where you’ll be asked about your health and family history.
You’ll also undergo several tests. These tests will help your
doctor get an accurate picture of your overall health. Tests may include:
- chest X-ray
Here are some ways your doctor may ask you to prepare for
- Stop any
medication that affects how your blood clots. Many pain relievers and heart
medications affect clotting. You shouldn’t stop these drugs on your own, but only if your
doctor tells you to do so.
smoking. It’s bad for your heart and increases healing time.
your doctor if you experience symptoms of a cold or flu. Heart infections can
become very serious.
your home, and make arrangements for your weeklong hospital stay.
- Wash your
body with a special soap the day before the procedure. This reduces the risk of
- Fast, which
includes no drinking water, beginning at midnight before your surgery.
- Take any and all medications your doctor gives you.
How Heart Bypass Surgery Is Performed
Before the Surgery
Prior to surgery, you’ll change into a hospital gown and be given
an IV. Through this IV, you’ll receive medication, fluids, and anesthesia. When
the anesthesia begins working, you’ll fall into a deep, painless sleep.
Your surgeon will start by making 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 that 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.
What Is It Like to Recover from Heart Bypass Surgery?
When you wake up from heart bypass surgery, there will be a tube
in your mouth. You may also feel pain or have side effects from the procedure,
- 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. Be prepared to stay in the hospital for
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)
plenty of rest
- refraining from physical activity
Even without any complications, recovery from heart bypass
surgery can take between six and 12 weeks. That is the minimum amount of time
it takes for the breastbone to heal. Anyone that undergoes heart bypass surgery
should avoid all heavy exertion, limiting physical activity as much as possible
and being careful not to lift objects over 10 pounds. Those recovering should
also avoid driving until they receive approval from their doctor.
Most likely, your physician will recommend a
program of cardiac rehabilitation. This will involve a regimen of carefully
monitored physical activity, with occasional stress tests to see how the heart
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
pain in your chest
- rapid heart
- redness or discharge around the incision
Long-Term Effects of Bypass Surgery
The Mayo Clinic is optimistic about bypass surgery outcomes. They
state that after a successful heart bypass surgery, symptoms
like shortness of breath, chest tightness and high blood pressure should be
A bypass can fix a blocked artery, but you may need to change
some habits to prevent future heart disease. The best surgery outcomes are
observed in individuals that take this lifestyle changes seriously. But studies
show that, following bypass surgery, while most patients are interested in
resuming their pre-surgery lives, very few take a genuine interest in making
lifestyle improvements that would prevent future coronary events. Talk to your
doctor about dietary and other lifestyle changes to follow after surgery.