Coronary Artery Bypass Surgery: What to Expect Before, During, and After

Coronary artery bypass grafting (CABG), commonly known as bypass surgery, is a life-saving procedure performed to restore blood flow to the heart when coronary arteries become blocked or narrowed due to coronary artery disease (CAD). If you or a loved one has been recommended for bypass surgery, understanding the preparation, procedure, and recovery process can ease anxiety and help you achieve the best possible outcome. In this blog, we’ll cover everything you need to know about CABG surgery.

Why Is Coronary Artery Bypass Surgery Performed?

CABG surgery is performed when one or more coronary arteries become severely blocked due to plaque buildup (atherosclerosis). This blockage reduces oxygen-rich blood supply to the heart, increasing the risk of:

• Chest pain (angina)
• Heart attack (myocardial infarction)
• Heart failure
• Irregular heartbeats (arrhythmias)

When Is Bypass Surgery Necessary?

• Severe blockage in the coronary arteries that cannot be treated with medication or angioplasty.
• Multiple blocked arteries that affect the heart’s ability to pump blood.
• Failed stent placement in previous treatments.
• Serious heart disease symptoms affecting quality of life.

CABG improves blood circulation, reduces chest pain, and prevents heart attacks, allowing patients to lead a healthier life.  

Before the Surgery: Preparation & Preoperative Steps

1. Pre-Surgery Tests & Evaluations

Before undergoing bypass surgery, your cardiologist and surgical team will conduct various tests to assess your heart’s condition:

• Electrocardiogram (ECG/EKG): Measures heart rhythm and electrical activity.
• Echocardiogram: Uses ultrasound to assess heart function.
• Coronary Angiography: Identifies blockages in arteries using contrast dye and X-rays.
• Blood Tests: Checks for cholesterol levels, blood sugar, and overall health.
• Chest X-ray: Examines heart and lung health.

2. Lifestyle Adjustments Before Surgery

Your doctor will advise specific pre-surgery lifestyle changes to reduce surgical risks and improve recovery:

• Quit smoking – Smoking damages blood vessels and slows healing.
• Follow a heart-healthy diet – Reduce saturated fats, salt, and sugar.
• Control blood pressure and diabetes – Proper medication management is crucial.
• Stay active – Light physical activity can improve cardiovascular strength before surgery.
• Avoid alcohol and blood-thinning medications (aspirin, NSAIDs) before surgery.

Tip: Discuss all medications and supplements with your doctor, as some may need to be adjusted before surgery.  

During the Surgery: Step-by-Step Procedure

CABG is an open-heart surgery performed under general anesthesia, meaning you will be asleep and pain-free during the procedure.

Step 1: Anesthesia & Incision

• You will be given general anesthesia to ensure you stay unconscious during surgery.
• The surgeon makes an incision down the middle of the chest to access the heart.

Step 2: Heart-Lung Bypass Machine (if needed)

• In traditional CABG, a heart-lung machine is used to temporarily take over heart function while the heart is stopped.
• In "off-pump" CABG, surgery is performed while the heart continues to beat.

Step 3: Grafting Procedure

• The surgeon takes a healthy blood vessel (graft) from the leg (saphenous vein), chest (internal mammary artery), or arm (radial artery).
• The graft is attached to the blocked coronary artery, bypassing the blockage and restoring blood flow.

Step 4: Closing the Chest & Recovery Monitoring

• The chest bone is closed with stitches or surgical wires.
• The patient is transferred to the intensive care unit (ICU) for monitoring.

Duration: CABG surgery typically takes 3 to 6 hours, depending on the number of grafts placed. [caption id="attachment_4539" align="alignnone" width="1152"] Senior man suffering from chest pain at home[/caption]

After the Surgery: Recovery & Long-Term Care

1. Immediate Post-Surgery Recovery (Hospital Stay)

Hospital Stay: 5 to 7 days, depending on individual recovery.

First 24-48 Hours (ICU Stay)

• Monitored closely for vital signs, heart function, and pain control.
• Breathing tube (if used) is removed after a few hours.
• Encouraged to start light movement (sitting up, short walks).

Days 2-5 (General Ward Stay)

• Gradual increase in physical activity.
• Monitoring for complications (infection, irregular heartbeat).
• Pain management and breathing exercises.

2. Home Recovery & Lifestyle Adjustments

Total Recovery Time: 6 to 12 weeks

• Wound Care – Keep the chest incision clean and dry to prevent infections.
• Medication Management – Continue prescribed blood thinners, cholesterol-lowering drugs, and blood pressure medication.
• Physical Activity – Follow a gradual return to movement, starting with short walks and light stretching.
• Cardiac Rehabilitation – A structured exercise and education program designed to strengthen the heart.
• Dietary Changes – Follow a heart-healthy diet rich in fruits, vegetables, whole grains, and lean protein.

Tip: Avoid heavy lifting, smoking, alcohol, and high-stress situations for the first few months to promote healing.  

Frequently Asked Questions About Bypass Surgery

How long does a bypass surgery last?

A successful CABG can last 10-15 years or more, depending on lifestyle habits and overall health.

Will I need another bypass surgery in the future?

Some patients may require a second surgery if new blockages form. Maintaining a healthy lifestyle can help prevent this.

Can I live a normal life after bypass surgery?

Yes. With proper lifestyle changes and medical follow-ups, most patients resume normal activities, including work and exercise, within a few months.

What are the risks of bypass surgery?

While CABG is a safe and effective procedure, possible risks include infection, bleeding, irregular heartbeat (arrhythmia), and blood clots. However, choosing an experienced cardiac surgeon significantly reduces these risks.

Can I prevent the need for bypass surgery?

Yes. Preventative heart care includes:

• Eating a heart-healthy diet
• Regular exercise
• Managing cholesterol, blood pressure, and diabetes
• Quitting smoking
• Maintaining a healthy weight

Conclusion: Take Charge of Your Heart Health

Coronary artery bypass surgery is a lifesaving procedure that significantly improves heart function and overall quality of life. While the recovery process requires commitment and lifestyle changes, most patients enjoy a healthier, more active life after surgery. At Vive Hospital, our world-class cardiology team specializes in advanced bypass surgeries and personalized heart disease treatments. If you have been diagnosed with coronary artery disease, contact us today to discuss your treatment options. Your heart deserves the best care. Book a consultation with our expert cardiac surgeons at Vive Hospital today.