What is Heart Bypass Surgery?

A coronary artery bypass graft (CABG) or a heart bypass surgery is a surgical procedure performed to restore blood flow to parts of the heart that have been affected by blockages in the coronary arteries.

According to recent studies, nearly 24.8% of all deaths in India occur due to cardiovascular diseases. Coronary artery disease (CAD) is one of the significant contributors to the burden of cardiovascular diseases in the country.

Coronary Artery Disease (CAD) or atherosclerotic heart disease refers to the narrowing or blockage of the coronary arteries. This occurs due to a build-up of plaque or fatty deposits in these arteries.

The narrowing of the coronary arteries leads to a reduced blood supply to the heart. This causes several symptoms such as chest pain, breathlessness, palpitations etc. It could also lead to a heart attack or heart failure in severe cases.

A coronary artery bypass graft (CABG) or a heart bypass surgery is one of the recommended treatment options for patients diagnosed with CAD.

What are the types of heart bypass surgery?

A heart bypass surgery or CABG is usually recommended under the following circumstances –

1. If a blockage is found in all three arteries of the heart

2. If a blockage is located in the main artery to the heart (left main artery)

3. If two blockages are found in one or two arteries

Depending on the number of arteries that are blocked, your cardiologist at Max Hospital may recommend one of the following –

1. Single Bypass – When a single artery is blocked

2. Double Bypass – When two arteries are blocked

3. Triple Bypass – When three arteries are blocked

4. Quadruple Bypass – When a blockage is found in four arteries

When Bypass Surgery Required?

If the narrowing of coronary arteries is diagnosed in the early stages, your cardiologist may help you manage the condition through dietary and lifestyle changes and medication. However, if the block is more extensive, the doctor may consider angioplasty with stenting or a CABG (heart bypass surgery).

The choice of treatment depends on various factors. For example, doctors recommend heart bypass surgery when there is a blockage in three arteries (three-vessel coronary disease).

A blockage in the Left Descending Artery (LAD) is considered more serious and more likely to put the patient at risk of heart attack or heart failure. Therefore, CABG is preferred over angioplasty with stenting if there is a blockage in the LAD.

How is Heart Bypass Surgery Done?

The heart bypass surgery usually takes between 5 and 6 hours. During the surgery, the doctor will place you under general anaesthesia.

Once you are under anaesthesia, the surgeon performs a sternotomy to open up the chest region. The doctor will now place you under a heart-lung machine which will take over the cardiac and respiratory functions while the surgeon grafts the bypass. Next, the doctor takes a section of blood vessels, usually from the leg, to create a different pathway for the blood flow in the heart.

The surgeon will restart your heart when the graft is placed, take you off the heart-lung machine, and close the chest with wires.

You will be placed in cardiac ICU following the surgery, and doctors will closely monitor your heart function.

What are the risks of bypass surgery?  

Heart bypass surgery is an open-heart surgery that carries certain risks and complications. However, the expert cardiothoracic surgeons at Max Hospital have very high rates of success.

Risks of CABG surgery include -

1. Excess bleeding

2. Arrhythmia

3. Stroke

4. Heart attack

5. Clots

6. Infection

7. Kidney failure

8. Death

9. Allergic reaction to anaesthesia

The risks of developing complications from a CABG surgery increase when the patient suffers from comorbidities. If you suffer from diabetes, emphysema, kidney, or liver disease, you may want to discuss the risks with your surgeon. In the case of planned surgery, the surgeon may involve specialists from other departments and draw up a surgical plan to manage these conditions before proceeding to surgery.

What is the Recovery Time after a Heart Bypass?

Following the CABG surgery, you may need to stay in the Cardiac ICU for about 2-3 days. You may need to stay between 7 and 10 days following the surgery. Your doctor will take this time to monitor your health and heart function and get you back on your feet.

Between 6 and 8 weeks, you may be able to return to regular activities, including work. 

Heavy manual work may take longer, though. Complete recovery usually takes about 12 weeks.

Meanwhile, you must keep up with follow-up appointments with your doctor as recommended.

What are the benefits, and how long do they last?  

A CABG surgery can relieve symptoms like angina and improve the functioning of the heart. In addition, it considerably reduces the risk of a heart attack by restoring blood flow.

The benefits of heart bypass surgery can last from 10 -15 years. However, the life expectancy of patients increases considerably with a healthy lifestyle and regular treatment. Therefore, patients who have undergone CABG surgery are advised to quit smoking, maintain optimal weight, eat healthy, and control conditions like diabetes and hypertension with medication.

Patients who have undergone heart bypass surgery require regular follow-up and monitoring.

How is beating heart surgery different? Is it safe?

A beating heart coronary artery bypass surgery or an off-pump bypass surgery is the surgical procedure when the surgeon does not put you on a heart-lung machine and puts in the graft with the help of a tissue stabilizer.

A beating heart surgery reduces the chances of stroke and kidney damage and causes less blood loss. Both on-pump bypass and beating heart surgery are safe, and the surgeon will choose depending on your health condition and better chances of a successful outcome.

Following the CABG surgery, it is important to stay on regular follow-up and monitoring. This includes -

1. Following the treatment plan and taking medication

2. Staying stress-free

3. Making dietary and lifestyle changes

4. Going to cardiac rehab

5. Getting medical attention if you experience any discomfort

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