Coronary artery bypass surgery

What is a coronary artery bypass?

A coronary artery can become completely blocked, causing part of the heart muscle to die. The main benefit of coronary artery bypass is to reduce angina. Surgery may also improve your breathlessness and how well your heart works. Sometimes surgery can reduce the risk of you having a heart attack.

Are there any alternatives to this procedure?

A bypass operation is only suitable for certain types of coronary artery disease. For some people it may be possible to have a percutaneous coronary intervention (PCI) to widen or unblock an artery using a small inflatable balloon. Usually a stent (metal mesh tube) is used to hold the artery open. Coronary artery disease can be treated using drugs to relieve the symptoms and to help prevent the disease getting worse.

Without an operation, your angina may get worse.

What does a coronary artery bypass involve?

The operation is performed under a general anaesthetic and usually takes about three hours.

Your surgeon will make a cut down the front of your chest, through the breastbone (sternum). You will be connected to a heart-lung machine, which allows the heart to be still while the bypasses are performed. For each coronary artery that needs a bypass, your surgeon will take a length of blood vessel from elsewhere in your body, usually a vein from your leg or an artery from your arm or chest. They will use the blood vessel to bypass the blockage and so restore a good blood supply to your heart

You will then be disconnected from the heart-lung machine and your own heart will take over again. The wound is closed with wires and stitches.

Your bypass operation may be performed without using a heart-lung machine, which will mean a faster recovery. Your surgeon will advise if this is suitable.

For more information, and if you have any queries about the procedure, speak to your consultant.

Continue taking your normal medication unless you are told otherwise.

The following lifestyle changes can help make the procedure a success:

• Giving up smoking
• Eating healthily. If overweight, you have a greater chance of developing complications
• Exercising regularly. Your GP can recommend exercises.

Possible complications can include:

• Pain, which happens with every operation
• Bleeding after surgery
• Unsightly scarring of the skin, although a midline chest wound usually heals neatly
• Stroke. The risk depends on your age and if you have a history of stroke
• Infection in the chest wound, which is common. If this happens, you may need antibiotics and sometimes further treatment
• Heart attack.

This is not a definitive list and symptoms will vary with each patient. Please ask your consultant for more information.

What is the recovery like?

You should be able to go home seven to ten days after the operation. However, your doctor may recommend that you stay a little longer. Remember, you won’t be able to drive after the operation.

Regular exercise should help your recovery – ask your GP for advice. Most people make a good recovery. However, symptoms can come back. If this happens you may need repeat surgery, usually ten or more years following the original operation.

For further information, speak to your consultant.

How to pay for your operation

Coronary artery bypass costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own treatment the cost of the operation will be explained and confirmed in writing when you book the operation. Ask the hospital for a quote beforehand, and ensure that this includes the surgeon’s fee, the anaesthetist’s fee and the hospital charge for your procedure.