What you can expect
Before the procedure
If your coronary bypass surgery isn't performed as emergency surgery, you'll likely be admitted to the hospital the morning of the surgery.
During the procedure
Coronary bypass surgery generally takes between three and six hours and requires general anesthesia. The number of bypasses you need depends on where in your heart and how severe your blockages are.
For general anesthesia, a breathing tube is inserted through your mouth. This tube attaches to a ventilator, which breathes for you during and immediately after the surgery.
Most coronary bypass surgeries are done through a long incision in the chest while a heart-lung machine keeps blood and oxygen flowing through your body. This is called on-pump coronary bypass surgery.
The surgeon cuts down the center of the chest, along the breastbone. He or she then spreads open the rib cage to expose the heart. After the chest is opened, the heart is temporarily stopped with medication and a heart-lung machine takes over to circulate blood to the body.
The surgeon takes a section of healthy blood vessel, often from inside the chest wall or from the lower leg, and attaches the ends above and below the blocked artery so that blood flow is redirected around the narrowed part of the diseased artery.
Other surgical techniques your surgeon might use include:
- Off-pump or beating-heart surgery. This procedure allows surgery to be done on the beating heart using special equipment to stabilize the area of the heart the surgeon is working on. This type of surgery is challenging because the heart is still moving. It's not an option for everyone.
- Minimally invasive surgery. A surgeon performs coronary bypass through small incisions in the chest, often with the use of robotics and video imaging that help the surgeon operate in a small area. Variations of minimally invasive surgery might be called port-access or keyhole surgery.
After completing the graft, the surgeon will restore your heartbeat, disconnect you from the heart-lung machine and use wire to close your chest bone. The wire will remain in your body after the bone heals.
After the procedure
Expect to spend a day or two in the intensive care unit. The breathing tube will remain in your throat until you are awake and able to breathe on your own.
Cardiac rehabilitation often begins while you're still in the hospital. You'll be given a program of exercise and education designed to help you recover. You'll continue with monitored programs in an outpatient setting until you can safely follow a home-based maintenance program.
Barring complications, you'll likely be discharged from the hospital within a week. You still might have difficulty doing everyday tasks or walking a short distance. If, after returning home, you have any of the following signs or symptoms, call your doctor:
- Rapid heart rate
- New or worsened pain around your chest wound
- Reddening around your chest wound or bleeding or other discharge from your chest wound
Expect a recovery period of about six to 12 weeks. In most cases, you can return to work, begin exercising and resume sexual activity after four to six weeks, but make sure you have your doctor's OK before doing so.