What is coronary artery bypass surgery?
Coronary artery bypass surgery is a surgery to treat coronary artery disease. The surgery helps blood make a detour, or bypass, around one or more narrowed or blocked coronary arteries. Coronary arteries are the blood vessels that bring blood to the heart. The surgery is also called bypass surgery or coronary artery bypass graft (CABG).
Your doctor will make a bypass using a piece of blood vessel from another part of your body. Your doctor will attach, or graft, this blood vessel above and below the narrowed or blocked section of your artery.
Why is coronary artery bypass surgery done?
Bypass surgery is done to treat a heart attack and coronary artery disease. Surgery might be an option for many reasons. These reasons include the following:
- Your left main heart artery is very narrow.
- Multiple arteries of the heart are blocked or the amount of blood flowing through them is very low.
- You are going to have surgery to repair or replace a heart valve.
- You have diabetes and two or more narrowed or blocked arteries.
- Your heart is having trouble pumping. This is called a decreased ejection fraction.
Whether surgery is an option for you also depends on your age, your health, and how much your angina is affecting your quality of life. Your doctor is likely to recommend bypass surgery only if you will benefit from it and if those benefits are greater than the risks. You and your doctor can work together to decide if you want to have surgery.
How is coronary artery bypass surgery done?
The most common way to do bypass surgery is through a large cut, called an incision, in the chest. This is called open-chest surgery.
Your doctor will make the cut in the skin over your breastbone (sternum). Then the doctor will cut through your sternum to reach your heart and coronary arteries.
The doctor will likely connect you to a heart-lung bypass machine. This machine will let the doctor stop your heart during the surgery. The doctor will use a blood vessel from your chest, arm, or leg to bypass the narrowed or blocked arteries. When the blood vessels are in place, the doctor will restart your heart.
The doctor may use wire to put your sternum back together. The wire will stay in your chest. You will get stitches or staples to close the cuts in your skin. The cuts will leave scars that may fade in time.
Some hospitals offer less invasive bypass surgery. This includes surgery that is done without stopping the heart. The surgery also may be done through smaller cuts in the chest.
After coronary artery bypass graft: When to call
Call 911 anytime you think you may need emergency care. For example, call if:
- You passed out (lost consciousness).
- You have severe trouble breathing.
- You have sudden chest pain and shortness of breath, or you cough up blood.
- You have severe pain in your chest.
- You have symptoms of a heart attack. These may include:
- Chest pain or pressure, or a strange feeling in the chest.
- Sweating.
- Shortness of breath.
- Nausea or vomiting.
- Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
- Lightheadedness or sudden weakness.
- A fast or irregular heartbeat.
- You have angina symptoms (such as chest pain or pressure) that do not go away with rest or are not getting better within 5 minutes after you take a dose of nitroglycerin.
- You have symptoms of a stroke. These may include:
- Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
- Sudden vision changes.
- Sudden trouble speaking.
- Sudden confusion or trouble understanding simple statements.
- Sudden problems with walking or balance.
- A sudden, severe headache that is different from past headaches.
Call your doctor now or seek immediate medical care if:
- You have pain that does not get better after you take pain medicine.
- You have loose stitches, or your incision comes open.
- You are bleeding a lot from the incision.
- You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
- A fever.
- Your heartbeat feels very fast, skips beats, or flutters.
- You have signs of a blood clot in a leg. If you had a vein removed from your leg, you may have tenderness and swelling while your leg heals. But signs of a blood clot may be in a different part of your leg and may include:
- Pain in your calf, back of the knee, thigh, or groin.
- Redness and swelling in your leg or groin.
- You have symptoms of heart failure, such as:
- Swelling in your legs, ankles, or feet.
- Sudden weight gain, such as more than 2 to 3 pounds in a day or 5 pounds in a week. (Your doctor may suggest a different range of weight gain.)
- You are sick to your stomach or cannot keep fluids down.
Watch closely for changes in your health, and be sure to contact your doctor if:
- You do not get better as expected.
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