Before surgery, inform your physician of any health issues you have and begin eating a diet low in unhealthy fats, salt and added sugars.
Your surgeon will put you into an inducing a deep sleep before performing a surgical cut through the center of your chest along the breastbone (sternum). They’ll open and spread your rib cage to see your heart before initiating the heart-lung machine.
What Is Bypass Surgery?
Bypass surgery helps restore blood flow to your heart by creating detour routes (grafts) around any blockages in its way, typically via veins in your leg or an artery in your arm.
Under general anesthesia, the surgery is conducted pain-free and sleep-like state. Your care provider then inserts a tube into your throat that helps facilitate breathing during and after surgery.
A surgeon makes a 6- to 8-inch incision through the sternum (breast bone) and opens your chest, in order to access your heart. They may take an artery or vein from either inside your chest wall (internal mammary artery) or from outside your ribs in order to access your heart and remove or sew up blood vessels while administering medicine to stop your heartbeat temporarily, before turning over circulation of your blood to the heart-lung machine for oxygen delivery and circulation.
Some individuals opt for CABG through less invasive means, with smaller incisions or without using the heart-lung machine (off-pump surgery). This technique is generally reserved for more severe blockages that don’t respond well to less invasive approaches like angioplasty with stenting.
How Is Bypass Surgery Done?
Your surgeon makes an incision through the middle of your breastbone and spreads open your rib cage, then temporarily stops your heart with medicine before connecting you to a machine that pumps blood during surgery.
Your surgeon will remove a section of healthy blood vessel (known as a graft ) from another part of your body and attach one end of it to your aorta (the large blood vessel that runs from your heart) while another end goes around any blocked coronary arteries. You may need one, two or even more grafts depending on where blockages exist in your system.
Some doctors offer new surgical approaches for heart bypass without stopping your heart, such as minimally invasive (keyhole) techniques and off-pump procedures. Unfortunately, these may not be widely available or appropriate for everyone; your doctor can let you know whether these techniques are right for you.
What Can I Expect From Bypass Surgery?
During surgery, you’ll be sedated. A tube will be placed into your throat to aid breathing while a surgeon makes an incision (cut) in your breastbone or chest. They then separate your sternum to access your heart; may remove a vein or artery from one leg or arm and attach one end to an artery above and one end below; thus diverting blood around any blockages and restoring circulation to your heart.
Your physician will prescribe medications to increase survival and lower the risk of complications, including blood clots. These may include blood thinners, cholesterol-lowering agents and aspirin; you should take them according to prescription. In addition, cardiac rehabilitation programs are sometimes recommended in order to help you return to regular activities more quickly; you’ll likely also be advised on eating a diet low in fat and sodium.
How Long Will Bypass Surgery Take?
Coronary Artery Bypass Surgery (CABG) generally lasts three to six hours. Surgeons harvest blood vessels from your leg or arm and use them as detours around any blockages in your coronary arteries that have diseased portions; these new blood vessels are known as grafts.
Before your procedure, your physician may perform an imaging test to check for blockages in your heart and arteries. A left coronary artery cathetherization (CACS) procedure uses a catheter inserted through blood vessels into the heart and arteries and then injecting dye that highlights blockages on X-ray images.
If your lungs are weak, the medical team may use a heart-lung machine during surgery to help with breathing. After surgery, nurses will assist you in getting up from bed and caring for yourself as your chest bone heals. After leaving hospital care, your physician is likely to recommend cardiac rehabilitation — an exercise and lifestyle education program designed to prevent further heart problems in future.