Coronary heart disease
Learn about Coronary heart disease (CHD, also known as Ischaemic Heart Disease or IHD), including causes, symptoms, diagnosis, treatments and prevention.
This short video explains what heart bypass surgery is, why you might need surgery and what to expect during and after surgery.
Heart bypass surgery explained
What’s heart bypass surgery?
Coronary bypass surgery is a type of surgery where ‘bypasses’ are created around narrowings or blockages in the arteries of your heart, to help bring back blood supply to it.
When you have a blocked or narrow artery around your heart, coronary bypass surgery creates a new route for blood to flow to your heart muscle. A healthy vessel from your chest or leg is removed and reused as a new path around your heart.
You might be recommended surgery if your arteries cannot be treated with coronary angioplasty or stenting. You may also be offered surgery if multiple arteries are affected, or you have other problems with your blood vessels.
Surgery decisions
Do I need heart bypass surgery?
You may need bypass surgery if you’ve been diagnosed with coronary heart disease. Coronary heart disease is when your coronary arteries (which move blood to the heart) get narrowed or blocked by a build-up of fatty material within their walls.
The build-up of material is a condition called atherosclerosis, which can cause:
- Angina – usually a pain or discomfort in your chest when your heart muscle isn’t getting enough blood
- Heart attack – when the fatty material hardens and bursts it can become a blood clot which can block your artery and cut off the supply off.
- Peripheral arterial disease (PAD) – when your arteries become narrow so blood cannot get to your leg muscles, causing pain in your calves, hips, buttocks and thighs – usually when you’re walking or exercising
- Stroke - when the blood supply to your brain is blocked.
If your doctor is recommending surgery, it’s because they think it’s the best option for you. Your doctor will recommend the treatment they think is best for you based on your individual condition and health. You can talk it through with them. In some cases, doctors may decide the best treatment for you. For example, if you need emergency surgery because of a heart attack or cardiac arrest.
It’s important to remember that some conditions may not get better without surgery. Talking it through with your doctor can help you make the decision that’s right for you.
It’s ok to ask questions, even things that feel difficult or uncomfortable to talk about.
What is the heart bypass surgery success rate?
The benefits and risks of heart bypass surgery are different for everyone and depend on the seriousness of your heart disease, the type of surgery you need, your age, and your overall health. The benefits of surgery include:
- Better blood flow, improved heart health and lower risk of heart attack.
- Better sleep – thanks to improved symptoms of conditions like less pain from angina and peripheral arterial disease.
- Better mood and mental health – due to reduced risk of angina, heart attack, stroke, peripheral arterial disease and other conditions caused by coronary heart disease.
- Bore energy – everyday tasks and physical activities become easier and more enjoyable.
If you’re worried about having heart surgery, speak to your healthcare professional. They can answer your questions and support you.
What are the risks of heart bypass surgery?
All types of surgery come with risk. Your hospital team should explain any risks to you before you have surgery Ask them if you have any questions or concerns, they can help prepare you for what to expect.
With heart bypass surgery, the risks can include:
- an irregular heartbeat
- bleeding
- blood clots
- failure of the graft to work as well as it should
- complications after surgery like a heart attack or stroke
- general anaesthesia that can cause short-term effects after surgery like confusion, lack of concentration, sickness and dizziness
- wound infection.
If you’re worried or have more questions, ask your doctor. They’ll be able to answer any questions specific to you and your surgery.
Preparing for surgery
What should I do before heart bypass surgery?
If your doctor recommends surgery, ask any questions you may have about it. You can then begin to prepare for the surgery, which can help reduce any stress and anxiety you may feel.
Being prepared may include:
- arranging for someone to look after you during recovery
- continuing to take medicine
- eating healthy foods
- managing your weight
- looking after your mental health
- organising transport to and from the hospital
- organising time off from work
- setting up a recovery space at home
- staying active.
Being prepared for surgery can help speed up the time it takes to recover. It can also help you feel less worried.
- Read our 5 top tips on getting in shape before surgery so you’re as prepared as possible.
During surgery
What happens during heart bypass surgery?
- Before the operation, you’ll be given medicine (general anaesthetic) that puts you to sleep and you will not feel pain. The medicine is injected or inhaled as a gas through a mask. A specialist doctor (called an anaesthetist) gives you the medicine before the surgery starts and stays with you to make sure you have enough to keep you asleep.
- You’ll then go into the operating room for the surgery which normally lasts 3 to 6 hours. Surgeons usually make a cut down the middle of the breastbone (the long flat bone in the middle of the chest) to reach your heart. If you have a vein graft from your leg or an artery graft from your arm, they will make smaller cuts in these places too.
- A heart-lung bypass machine will move the blood around your body while the surgeon operates on your heart. Some surgeons may carry out coronary bypass operations without this machine. This is called beating heart surgery.
- Your surgeon may do newer bypass surgeries like endoscopic or minimally invasive surgery. These involve making several small cuts and using a special camera to see the blood vessels and heart. Surgeons do this because it can help you get up out of bed sooner and speed up recovery.
- If your surgeon needs to cut your breastbone, you’ll have a wound down the middle of your chest. It’s normal to be worried or scared about having scars after surgery but you're not alone. Listen to people who have had heart surgery and how they learned to accept their scars.
Your surgeon will be around to answer any questions you may have before and after surgery. This includes talking about the different types of surgeries available to you.
Coronary bypass surgery is a type of surgery where ‘bypasses’ are created around narrowings or blockages in the arteries of your heart, to help bring back blood supply to it.
Recovery
What happens after heart bypass surgery?
- After your operation, you’ll be moved to intensive care (ITU) or a specialist recovery department, so you can be looked after.
- When you wake up you might feel confused and achy from the surgery.
- During your recovery, your nurse or doctor will do some checks to see how your body is recovering.
- When your doctor decides that you do not need intensive care anymore, you’ll be moved to the cardiac ward or the high dependency unit (HDU), so you can still be looked after carefully.
- You should generally be able to sit in a chair after one day, walk after 3 days and use stairs after 5 or 6 days. When you go home, you’ll need to relax for a few weeks.
You should be able to do most of your normal activities after about 6 weeks, including working, driving and sex. If you have a heavy manual job, you may need to rest for longer.
In many hospitals, after heart bypass surgery, a member of the cardiac specialist team will see you on the ward to give you information about your condition and the treatment you’ve had.
Things you may consider together are:
- 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.
- Cardiac rehabilitation (rehab) to get you fit and strong again.
- Your emotions feel after surgery - the team can help you if you want to talk with them.
You may find it helpful to write down questions or have someone with you to help remember the information you get throughout your journey.
It's important to look after your heart health so you do not develop more heart problems. Making healthy lifestyle changes can be hard at first, but it’s important for your overall quality of life.
Get support
As the day of your surgery gets closer, you may feel anxious, afraid, angry, worried about the future or glad that you’re about to have treatment.
It’s natural to have these feelings and it's important to talk about them with your partner, a friend, relative or healthcare professional.
- Speak to our cardiac nurses by phone, callback, email or online chat on Heart Helpline (Monday to Friday, 9am to 5pm).
- Read our article on how to cope with pre-surgery nerves for tips to feel better.
- Sign up to our Heart Matters magazine for online information packed with health and lifestyle advice.
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Learn how we make our health content.More information
What is cardiac rehabilitation?
Cardiac rehabilitation is a programme of exercise and information sessions to help you get back on your feet again after a heart attack, heart surgery or procedure.
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