The coronary arteries carry oxygen-rich blood to the heart muscle. When fatty deposits called plaque narrow them, the muscle may not get enough blood, causing angina (chest discomfort). Heart bypass surgery, or coronary artery bypass grafting (CABG), uses one of your own blood vessels, called a graft, to make another route.
A vein taken from the leg, for example, can be joined at one end to the aorta, the main artery carrying blood out of the heart, and stitched at the other end to a coronary artery beyond the blockage. Blood flows through the graft into that artery and on to the heart muscle it supplies. A chest artery can also be used: it can keep its original connection to the blood supply, with its free end joined beyond the blockage. In both cases, the blockage stays where it is.
Call triple zero (000) for severe, worsening or persistent chest pain, or chest discomfort with breathlessness, sweating, nausea or pain spreading to your arm, jaw or back.
Do not wait for a routine appointment or drive yourself to hospital.
You'll have a general anaesthetic, so you'll be asleep. In the usual operation, the surgeon makes a cut down the middle of your chest and divides the breastbone to reach the heart. Taking a graft from an arm or leg leaves another wound where that vessel was removed. Smaller cuts in the chest are possible for selected patients.
A heart-lung machine often pumps blood and supplies it with oxygen while the heart is temporarily stopped for the grafts to be attached. Some bypass operations are done while the heart keeps beating. If the breastbone was divided, the surgeon holds it together with wires or special surgical tape while it heals, and these are usually left in place.
You'll be cared for in intensive care or a similar unit, with monitors checking your heart, blood pressure and breathing. You may initially have a tube in your mouth connected to a breathing machine until you can breathe without it. You'll also have drips and drainage tubes, which are removed as you recover.
Once you're ready, you'll move to a hospital ward. Pain relief helps you breathe deeply and move more comfortably. A physiotherapist or nurse will help you start walking and show you breathing exercises. You can expect several days in hospital, but the length of your stay depends on your recovery.
Bypass surgery may be considered when several coronary arteries are affected, angina continues despite medicines, or the position and extent of the blockages make stents unsuitable. The aim is to relieve angina, and for some people surgery can also reduce the risk of a future heart attack.
Angioplasty treats the narrowing within the existing artery: a balloon widens it and a small metal mesh tube called a stent usually stays inside to hold it open. A bypass carries blood around the narrowing through a graft. To choose between them, your cardiologist and surgeon weigh the pattern of blockages and your symptoms against the risks of a major operation.
Bypass surgery improves blood flow but doesn't cure the disease that caused the arteries to narrow. Treatment continues after your wounds have healed, even if the chest pain has gone.
Your medicine plan may include treatment to reduce blood clots, lower cholesterol and control blood pressure. The hospital will explain which medicines to take when you go home. Keep taking them as prescribed and speak to your doctor or pharmacist if side effects are a problem.
Cardiac rehabilitation combines exercise suited to your recovery with practical advice about living with heart disease. It can help you build confidence with activity, understand your medicines and make changes such as stopping smoking. Programs may also include support for stress or low mood. Ask the hospital about a referral before you leave.
The hospital will tell you which checks you need before surgery and give you instructions about eating, drinking and medicines. Tell the staff about everything you take, including medicines for diabetes and blood thinners. Don't change these yourself. Plan for someone to take you home and help with meals or heavier household tasks during recovery.
Bleeding, wound infection and heart rhythm changes can occur after bypass surgery. Serious complications include kidney problems, stroke and heart attack, and some can be life-threatening. Your surgeon will explain how your health affects these risks and how they compare with your other treatment options.
Recovery takes weeks to months. If the breastbone has been opened, it needs time to heal. Follow the hospital's advice about lifting, driving, work and exercise.
Tiredness, poor sleep and changes in mood or concentration can happen after heart surgery. Mention these at your follow-up appointments, especially if they're getting worse or making daily life difficult. Contact the hospital or your doctor promptly if a wound becomes increasingly red, swollen or starts leaking, or if you develop a fever.
A valid referral from your GP or specialist is needed for a Heartscope cardiologist appointment. The cardiologist can review your symptoms and test results, discuss treatment and refer you to a heart surgeon if needed. The clinic can answer questions about the appointment.
Consultations are privately billed. If you're eligible, Medicare pays part of the consultation fee when you have a valid referral from your GP or specialist. The clinic will confirm the amount left to pay before the visit.
Heartscope doesn't perform bypass surgery at its clinics. The operation is done in hospital, and hospital, surgeon and anaesthetic fees are separate from the Heartscope consultation. The hospital and treating providers confirm those costs.
Heartscope cardiologists see patients at clinics in Melbourne and Queensland. If you have a referral, our team can confirm the location and appointment details.
View clinic locationsNo. It takes place in hospital. Heartscope cardiologists may be able to see patients with a valid referral from their GP or specialist, and can refer you to a heart surgeon when appropriate.
A double bypass means two coronary arteries are bypassed during one operation, and a triple bypass means three.
It can happen over time. Medicines and ongoing care after surgery help reduce the chance of further heart problems. Tell your doctor about new or returning chest discomfort.
Don't wait for the operation date to report a change. Contact your treating doctor if symptoms become more frequent or affect activities you could previously manage. For severe, worsening or persistent chest pain, follow the urgent care advice above.
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