Before the procedure
If coronary artery bypass surgery is a scheduled procedure, you are usually admitted to the hospital the morning of the surgery. You have many heart tests and blood tests the days and hours before surgery.
During the procedure
Coronary artery bypass surgery is major surgery that's done in a hospital. Doctors trained in heart surgery, called cardiovascular surgeons, do the surgery. Heart doctors, called cardiologists, and a team of other health professionals help care for you.
Before you go into the operating room, a healthcare professional inserts an
IV into your forearm or hand and gives you medicine called a sedative to help you relax.
When you are in the operating room, you can expect these things:
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Medicines.
You get a combination of medicines through the
IV and a face mask. These medicines put you in a pain-free, sleep-like state. This is called general anesthesia.
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Breathing machine. A healthcare professional puts a breathing tube into your mouth. This tube attaches to a breathing machine called a ventilator. The machine breathes for you during and immediately after the surgery.
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Heart-lung machine. During surgery, a heart-lung machine keeps blood and oxygen flowing through your body. This is called on-pump coronary bypass.
Coronary artery bypass surgery usually takes about 3 to 6 hours. How long surgery takes depends on how many arteries are blocked.
During
CABG, a surgeon typically makes a long cut down the center of the chest along the breastbone. The surgeon spreads open the rib cage to show the heart. After the chest is opened, the heart is temporarily stopped with medicine. The heart-lung machine is turned on.
The surgeon removes a section of healthy blood vessel, often from inside the chest wall or from the lower leg. This piece of healthy tissue is called a graft. The surgeon attaches the ends of the graft below the blocked heart artery. This creates a new path for blood to flow around a blockage. More than one graft may be used.
Some variations of coronary artery bypass surgery include:
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Off-pump or beating-heart surgery. Sometimes a heart-lung machine is not used during coronary artery bypass surgery. Instead the surgery is done on the beating heart. Special equipment stabilizes the specific area of the heart being worked on. This type of surgery can be challenging because the rest of the heart is still moving. It's not an option for everyone.
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Minimally invasive surgery. A heart surgeon does the surgery through small cuts in the chest. Minimally invasive heart surgery might be called port-access or keyhole surgery.
After the surgery is done, the healthcare team restores your heartbeat in the operating room and stops the heart-lung machine. The surgeon uses wire to close the chest bone. The wire stays in your body after the bone heals.
After the procedure
After coronary artery bypass surgery, your healthcare team checks on you and makes sure you are as comfortable as possible. You may feel sore and confused when you wake up. You can usually expect the following:
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Breathing tube. The breathing tube stays in your throat until you wake up and can breathe on your own.
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Hospital stay. Expect to spend 1 to 2 days in a hospital intensive care unit. How long you stay in the hospital depends on how you recover and if you have complications. Some people who have coronary artery bypass surgery go home within a week.
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Heart rhythm and breathing checks. Your healthcare team watches you closely after surgery to check for complications and to take your temperature. Machines record your breathing and heart rhythm.
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Medicines. You get medicines to reduce pain and prevent complications such as blood clots. If you don't already take a daily aspirin, your healthcare professional may recommend you do so. You may need to take the aspirin every day for life. There are specific medical recommendations about who benefits from aspirin therapy. Talk with your healthcare professional about aspirin use.
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Cardiac rehabilitation. Often called cardiac rehab, this supervised program of education, counseling and exercise helps improve heart health after heart surgery. You'll be encouraged to start moving and walking while you're still in the hospital. When you go home, you continue cardiac rehab at a medical center until you can safely follow a home program.
After surgery and when you're at home, you need to watch for symptoms of complications. Call your healthcare team if you have:
- Fever.
- Rapid heart rate.
- Pain around your chest wound that is new or gets worse.
- A change in skin color around your chest wound.
- Bleeding or other discharge from your chest wound.
It usually takes about 6 to 12 weeks to get better after coronary artery bypass surgery. With your healthcare team's OK, you can usually drive, return to work or the gym, and have sex after 4 to 6 weeks. But everyone recovers differently. Ask your healthcare professional for guidance.