Medically reviewed by: Prof. A. Rathinavel – M.S., M.Ch (Cardiothoracic Surgery) & Dr. K.M. Nisamudeen – M.D. D.M. Cardiology FSCAI, FCSI (Consultant Intervention Cardiologist)
When the arteries that supply blood to the heart become narrowed or blocked, the heart may not receive enough oxygen rich blood. In some cases, medicines or other treatments may not be enough, and surgery may be recommended to restore blood flow.
This is where CABG surgery may come in. Also known as heart bypass surgery, coronary artery bypass grafting creates a new route for blood to reach the heart muscle by using a healthy blood vessel from another part of the body.
What Is CABG Surgery?
CABG stands for coronary artery bypass grafting. It is a procedure used to improve blood flow to the heart when one or more coronary arteries are narrowed or blocked.
During the procedure, a healthy blood vessel is taken from another part of the body and connected above and below the blocked section of the coronary artery. This creates a new pathway for blood to reach the heart muscle.
The blood vessel used for the graft may come from the chest or arm, or a vein may be taken from the leg.
Why Might Someone Need CABG?
Not every person with coronary artery disease needs bypass surgery. Your cardiologist will consider the location and severity of the blockages, your symptoms, overall health, and whether other treatments are suitable.
CABG may be recommended when a blockage or narrowing is affecting blood supply to the heart and nonsurgical treatment is not an appropriate option. It may also be considered in certain emergency situations, including severe heart attacks.
Some symptoms associated with coronary artery disease can include:
- Chest pain
- Shortness of breath
- Severe tiredness
- Palpitations
- Abnormal heart rhythms
- Swelling in the hands and feet
- Indigestion
It is also possible to have coronary artery disease without noticeable symptoms in its early stages.
What Happens During a CABG Procedure?
The exact approach depends on the patient’s condition and the surgical plan.
In traditional open heart surgery, the breastbone is opened to give the surgeon access to the heart. The heart is temporarily stopped, while a heart lung bypass machine takes over the work of pumping blood through the body. The surgeon then attaches the graft vessels around the blocked arteries.
Depending on the situation, an off pump approach may also be considered. In this technique, the heart continues to beat while the surgeon performs the bypass. Minimally invasive and robotic techniques have also been developed for selected patients.
The number of bypass grafts required depends on how many arteries are blocked and where those blockages are located.
What Is the Difference Between On Pump and Off Pump CABG?
The main difference is whether the heart is temporarily stopped during surgery.
On pump CABG
The heart is stopped temporarily, and a heart lung bypass machine circulates blood through the body while the surgeon performs the bypass.
Off pump CABG
The heart continues beating during the procedure. The area around the coronary artery is stabilised so the surgeon can attach the graft while the rest of the heart continues to pump blood.
The choice between these approaches depends on the patient’s condition and the surgeon’s assessment.
What Is CABG Procedure and Recovery Like?
Recovery does not end when the surgery is completed. After the operation, patients are usually monitored closely in the hospital, often beginning in an intensive care setting.
A breathing tube may remain in place until the patient is awake and able to breathe independently. Once stable, the tube is removed and the patient gradually begins drinking fluids, eating, sitting up and walking. Early movement is encouraged because it can help reduce complications such as pneumonia and blood clots.
The hospital stay is generally several days, although the exact duration varies from person to person.
At home, patients need to follow their healthcare team’s instructions regarding wound care, medicines, physical activity and driving. Follow up appointments are also important during this period.
How Long Does Heart Bypass Surgery Recovery Take?
Recovery is gradual. Soreness around the surgical incision is common in the early days, and activity is usually increased step by step as the body heals.
Your care team may eventually recommend cardiac rehabilitation. It can begin with simple walking during the hospital stay and progress toward regular physical activity and heart healthy eating habits.
There is no single recovery timeline that applies to everyone. Age, overall health, the complexity of the surgery and any complications can all influence recovery.
What Are the Risks of CABG?
Like any major surgery, bypass surgery has possible risks and complications.
These can include:
- Bleeding
- Blood clots
- Infection
- Pneumonia
- Breathing problems
- Abnormal heart rhythms
- Kidney problems
- Graft failure
- Heart attack or stroke
- In rare cases, death
The risks can vary depending on a person’s individual medical condition, so it is important to discuss them with your cardiac care team before surgery.
What Can Help After Bypass Surgery?
Surgery can improve blood flow, but looking after heart health remains important afterwards.
Your doctor may recommend medicines, dietary changes, regular physical activity, cardiac rehabilitation and other heart healthy habits. These measures can help manage the underlying heart disease and reduce the risk of future problems.
For patients looking for CABG surgery in Madurai, choosing a cardiac care team that can guide you through evaluation, surgery and follow up care can make the treatment journey easier to understand.
When Should You Seek Medical Help After Surgery?
Some symptoms during recovery should not be ignored.
Contact your healthcare provider if you develop fever, chills, increasing redness or swelling around the incision, fluid or bleeding from the wound, increasing pain, an unusually fast or irregular pulse, leg swelling, numbness or persistent nausea or vomiting.
Seek emergency medical attention for severe breathing difficulty or warning signs of a heart attack such as chest pain, shortness of breath, pain in the arm, neck or jaw, cold sweating or lightheadedness.
Frequently Asked Questions
Is CABG the same as heart bypass surgery?
Yes. CABG is commonly called heart bypass surgery. Both terms refer to coronary artery bypass grafting, a procedure that creates a new route for blood to reach the heart muscle.
What is coronary artery bypass graft surgery used for?
Coronary artery bypass graft surgery is used to improve blood flow to the heart when coronary arteries are narrowed or blocked and other treatment options may not be suitable.
Is CABG always an open heart surgery?
Traditional CABG is an open heart procedure, but other approaches, including off pump and selected minimally invasive or robotic procedures, may be possible for some patients. The appropriate approach depends on individual circumstances.
What does heart bypass surgery recovery involve?
Heart bypass surgery recovery involves hospital monitoring followed by gradual increases in activity, wound care, medicines, follow up appointments and, when recommended, cardiac rehabilitation.
Is bypass surgery a permanent cure for coronary artery disease?
CABG creates a new route for blood flow around blocked arteries, but it does not remove the underlying risk factors for coronary artery disease. Continuing prescribed treatment and maintaining heart healthy habits remain important after surgery.
A heart bypass can sound overwhelming when you first hear the words. But understanding what the surgery does, why it may be recommended and what recovery involves can make the process a little less uncertain.
If your doctor has recommended bypass surgery, ask questions, understand your treatment options and discuss the expected benefits and risks based on your individual condition.