Coronary bypass surgery

Coronary or heart bypass surgery can relieve chest pain. In the operation, your surgeon uses a blood vessel from your leg, arm or chest to bypass a narrowed section of a coronary artery.


Why might I need bypass surgery?

If you’ve been diagnosed with coronary heart disease or angina, your doctor might suggest a bypass operation to help improve the blood supply to your heart muscle. This will help to relieve angina symptoms and improve your quality of life.

What happens during bypass surgery?

Bypass surgery
A diagram of your heart after bypass surgery.
Your arteries get narrowed when fatty deposits build up on the inner walls of your arteries. The aim of coronary bypass surgery is to bypass – or ‘get around’ - the narrowed sections of your coronary arteries.

The surgeon does this by grafting a blood vessel between the aorta (the main blood vessel leaving the heart) and a point along the coronary artery, past the narrowed area.

In most cases, at least one of the blood vessels used as a bypass graft is an artery from your chest called the internal mammary artery.

Blood vessels such as a vein from your legs and sometimes an artery from your arms are used for the other grafts. You can have one graft, but it’s more common to have two, three or four (often called double, triple or quadruple bypasses).

The operation

Surgeons usually make a cut down the middle of the breastbone to reach your heart. But in some operations the breastbone doesn't need to be cut. This is called minimally invasive surgery.

If your surgeon needs to cut your breastbone, you will have a long wound down the middle of your chest. If you have had a vein graft from your leg or an artery graft from your arm, you will have a smaller wound in these places too.

A heart-lung bypass machine circulates the blood around your body while the surgeon operates on your heart, but some surgeons carry out coronary bypass operations without this machine. This is called beating heart surgery.

After your operation you will be moved to intensive care for close monitoring until you wake up. Once your condition is stable, you will be moved to the high dependency unit or the cardiac ward.

The benefits

Most people get excellent relief from angina and improved quality of life. 

The risks

The risks are different from person to person, depending on the severity of heart disease, type of operation, age, and current state of health.

Recovery

Out of bed in a day or two, return home after a week, full recovery after two or three months, depending on your fitness, age and how severe the problem was.

What should I do when I go home?

In many hospitals a member of the cardiac rehabilitation team will see you on the ward to give you information about your condition and the treatment you have had.

They will talk to you about making lifestyle changes and how to reduce your risk factors (the things that increase your risk of heart disease) to help protect your heart in the future. You can also ask the rehabilitation staff any questions about your recovery.

Surgery is not a cure - so it's important to look after your heart health long term.

Who can I talk to?

As the day of your surgery gets closer, you may be feeling a whole range of emotions. You may feel anxious, afraid, angry, worried about the future or glad that you are about to have treatment. It’s natural to have these sort of feelings and it's important to talk about them with your partner, a friend, relative or healthcare professional.

If you have any questions, talk to your doctor or call our Heart HelpLine on 0300 330 3311.