Coronary Artery Bypass Surgery

What is coronary artery bypass surgery (CABG)?

Coronary artery bypass surgery is an operation where veins taken from the leg or an artery is taken from behind the breastbone or the arm and these are used to bypass blocked or narrowed coronary arteries so that blood can flow more easily. The new blood vessel (the graft) is attached from the main blood vessel in the chest (the aorta) and runs to a point in the coronary artery beyond the blockage.

How is the operation performed?

The operation is performed under a general anaesthetic (you will be asleep during the operation) and takes around three hours, but can take longer. The most usual scar is down through the middle of the breast bone, though in some cases much smaller incsions can be made. Blood vessels that are being used from your leg or arm will be removed and prepared at the start of the operation. The new grafts will then either be sewn in while the heart is still beating ('off-pump' surgery), or the heart is temporarily stopped and a heart-lung (bypass) machine is used to provide the rest of the body with the blood and oxygen.

What happens afterwards?

After a CABG, you will be taken to the intensive care unit (ICU) and will be closely monitored for about 24 hours before you go back to your ward. When you wake up you will be connected to machines that record the activity of your heart, lungs and other body systems. These might include a ventilator machine to help you breathe. You may need pain relief to help with any discomfort as the anaesthetic wears off. You may have a catheter to drain urine from your bladder into a bag. You may also have fine tubes running out from the wound. These drain fluid into another bag and are usually removed after a day or two.
You will be encouraged to get out of bed and move around as this helps prevent chest infections and blood clots in your legs. A physiotherapist will usually visit you every day to guide you through exercises designed to help your recovery. When you are ready to go home, you will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours. Your nurse will give you some advice about caring for your healing wounds before you go home. You may be given a date for a follow-up appointment. The wires holding your sternum together are permanent. Dissolvable stitches will disappear in seven to 10 days on their own.

A CABG usually requires around a week to recover in hospital.

Recovering from CABG

You will be provided with advice about pain relief and painkillers before discharge. The breast bone takes about six weeks to heal but a full recovery can take two to three months. You will be seen by the cardiac rehabilitation team in hospital and advised about activities on going home and returning to work.

What are the risks?

CABG is a common procedure and is generally safe. However, your surgeon will tell you about possible risk of this procedure. Complications of a CABG are rare but can include heart attacks, stroke and not surviving the whole procedure It is important to remember that the surgeon will only be performing the operation if it is felt that the benefits to you, your symptoms and life afterwards outway the risks and doing nothing may carry a higher risk.

What about driving?

Follow your surgeon's advice about driving. You shouldn't drive until you are confident that you could perform an emergency stop without discomfort. This is usually about four weeks after the operation. If you drive a lorry or a bus you need to notify the DVLA about your operation. You will be disqualified from driving for three months and you will need to take an exercise test before driving again.

Please note:

Every effort has been made to ensure that the information on this website is up-to-date and accurate. However, it is intended to serve as a guide only. Symptoms may vary and if you have any medical concerns you should always consult a healthcare professional.