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Heart Bypass (Coronary Artery Bypass Graft)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What is a heart bypass?

Heart bypass

 

A heart bypass, or Coronary Artery Bypass Graft (CABG), is a procedure that uses a blood vessel from part of your body to act as a bypass around a blocked heart vessel.

 

 

What do the coronary arteries do?

The heart is a large muscle that pumps blood around the body. To keep the heart Heart bypass anatomypumping, it needs oxygen and nutrients to be constantly delivered to it, in the form of blood. This blood gets to the heart muscle through large arteries that course around it (the coronary arteries). The arteries can therefore be thought of as the 'pipes that bring fuel to the heart pump'. Without adequate fuel, the pump will fail.

 

How do the coronary arteries get blocked?

The arteries can become narrowed by atherosclerosis - this is fat that has been laid down on the inside of the artery. The fat can build up, blocking the flow of blood in the artery. This reduces how much blood gets to the heart, causing cramp-like pain in the heart muscle. This pain is felt as chest pain called 'angina'. As the blockage worsens you may start to feel short of breath at rest. Eventually, the artery may completely block, causing part of the heart muscle to die - a heart attack.

Artery blockage is more common in older people, but can still happen in younger life. Risk factors for such heart problems include:

  • Smoking

  • Strong family history of heart disease

  • High blood pressure

  • Diabetes

  • High cholesterol levels

 

Whilst you can't change your family history and genes, the other risks can be reduced by not smoking, exercising regularly, eating healthily and having a healthy body weight.

 

Are there any alternatives to heart bypass surgery?

This often depends on how severe the artery narrowing is. Very mild narrowing may need no surgery at all, although you may be started on medication. Often, the narrowing can be widened using a special inflatable balloon (angioplasty) - the area is then kept wide using a stent. Sometimes, though, a heart bypass may be the best treatment method. Your specialist will weigh up all your factors, and discuss possible options with you.

 

How is a heart bypass performed?

The surgeon makes a cut down the middle of the chest, over the breast-bone (sternum). The sternum is then split, allowing access to the heart. For each blocked coronary artery, the surgeon will need a length of blood vessel from elsewhere in order to perform the bypass. The vessels can be gathered from either the leg, arm or chest. The new vessel is now attached to the blocked heart artery, allowing blood to bypass the blockage.

The sternum is closed using wires and the skin stitched closed.

After the operation, the physiotherapy team will help you with walking, deep breathing and coughing, usually from day 2 onwards. You can usually go home after 7-10 days. Your team will be able to indicate when to get back to normal activities and driving.

 

What are the risks of heart bypass?

  • Blood clots in the legs - clots in the calf (deep vein thrombosis / DVT) can usually be treated with medication, but a DVT can (rarely) move to the lungs. This can cause breathing difficulty, or even be life threatening.

  • Infection - this may need antibiotics, or may possibly need a further procedure

  • Heart attack - whilst this procedure aims to reduce this risk, the strain of the operation can, in about 2 per 100, cause an attack.

  • Irregular heart beat - this may correct itself, or may need medication or even a 'mini-shock' to revert back to a normal heart rate

  • Stroke - the average risk is about 3 in 100, although can be greater if you have had previous strokes.

  • Pain - it is quite normal to feel sore for a few weeks after the operation, especially from the operation site at the breast bone

  • Death - the risk is about 2 in 100, but can vary according to how fit you are, age and other risk factors.

 

Read an account of a patient's Real Experience of heart bypass

 

Other SurgeryWise articles

You may also be interested to read our articles on angioplasty or angiograms

 

 

Any procedure involving skin incision can also result in unfavourable scarring, wound infection, or bleeding. This list of risks is not exhaustive, and you should discuss possible complications with your specialist. Whilst these risks will seem very worrysome, and indeed can be serious, it should also be borne in mind that many people have no postoperative problems whatsoever.

The information provided is as a guide only and you should discuss matters fully with your specialist before deciding if this is the right procedure for you. Please also read our disclaimer

 

 

 
 
 
 
 

 

 

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