heart bypass surgery Images (Click to view larger image)
coronary artery bypass graft surgery, CABG, coronary revascularisation, coronary bypass
Heart bypass surgery is an open-heart surgery that is done to reroute or "bypass" blood around clogged arteries. Arteries are the tubes in which blood flows to and from the heart. Over time they can become blocked by a buildup of plaque, which is a combination of fat, cholesterol, and other substances. This blockage, known as arteriosclerosis, lowers the blood and oxygen supply to the heart. Heart bypass surgery, also known as coronary artery bypass graft surgery or CABG, reroutes the blood around these clogged arteries.
How is the procedure performed?
The two most common forms of heart bypass surgery are:
A heart-lung machine is used during the surgery to keep the blood oxygenated while the heart isn't pumping.
- saphenous vein bypass. A large vein, called the saphenous vein, is removed from one of the legs. One end of the vein is attached to the aorta, the large artery leaving the heart, and the other end is connected to the coronary artery below the blockage.
- internal mammary artery bypass. An artery called the internal mammary artery, located behind the breastbone, is used to bypass the blocked coronary artery.
What happens right after the procedure?
After surgery, the person is taken right away to the intensive care unit, or ICU. He or she will be given medication for the first few hours to make him or her sleep. When the person awakens, he or she should not be alarmed to find:
The person will be given analgesia as needed.
- a breathing tube, called an endotracheal tube, down the windpipe. This tube is attached to a ventilator, or artificial breathing machine, to ensure deep breaths and to make it easier for the person to breath. This will be removed when he or she is awake, and able to take deep breaths.
- a stomach tube, called a nasogastric tube, in the nose to drain the stomach and prevent nausea and stomach swelling
- a narrow tube, called a urinary catheter, in the bladder to measure the amount of the urine the body is making.
- one or two tubes in the chest to prevent fluid build-up
- many intravenous, or IV, lines to give fluids and blood as needed
- a small tube in the wrist to monitor blood pressure closely
- a tube in the neck to monitor how well the heart is pumping and to allow an easy, painless way to draw blood
On the first day after surgery, many of the tubes will be removed. The person may be transferred to the step down unit, or telemetry unit, if there have been no problems. In the telemetry unit the person will:
The average hospital stay following heart bypass surgery is 4 to 7 days.
- be asked to breath deeply and cough often to prevent pneumonia
- be encouraged to sit at the edge of the bed and dangle his or her feet
- have the chest tube and urinary catheter removed
- eat, if possible, starting with clear liquids
- be given analgesia if it is needed
- begin walking within the first few days. This will help to prevent blood clots from forming, and reduce ankle swelling.
What happens later at home?
The recovery time at home will last for about 6 weeks. During this time, the incision will heal slowly, with some redness, tenderness and swelling present for several months. The person will be advised to:
This is a good time for a person to start thinking about changing his or her lifestyle and addressing any coronary risk factors that may have contributed to his or her heart problem. For instance, a person should:
- have a check-up with the surgeon about 10 to 14 days after the surgery
- take showers instead of baths for the first 2 weeks
- begin a walking program
- avoid lifting and straining for 4 to 6 weeks
- not drive for 3 to 4 weeks
- resume sexual activity as desired after the first check-up with the surgeon
- rest twice a day for the first few weeks, and get 8 to 10 hours of sleep at night
- expect some constipation if analgesia has been used often
What are the potential complications after the procedure?
- quit smoking if he or she smokes. Smoking after heart bypass surgery increases the risk of the bypass artery clogging again.
- control his or her blood pressure. If medication is prescribed, it should be taken as directed.
- follow a diet low in fat, cholesterol, and sodium.
- lose weight, if needed
- walk or do other exercise each day
Potential complications after a heart bypass operation are:
Author: Gail Hendrickson, RN, BS
- irregular heart beat, or arrhythmia
- clogging or blockage of the graft
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request