About heart bypass (coronary artery bypass graft) operations
Written by: Samer Nashef - Papworth Hospital
Updated: May 2007
Purpose of the operation
The main purpose is to relieve angina, especially if other less invasive methods are not suitable. Angina is a feeling of discomfort or pressure, usually felt in the middle of the chest, but sometimes in the arms, back, neck or jaw. It is an unpleasant feeling that occurs during exercise and goes away with rest. Because angina occurs on exertion, it can worsen your quality of life, limiting what you can do and enjoy.
The other purpose of the operation is to cut down the risk of heart attacks in the future. In some patients, the narrowing and blockages of arteries in the heart make heart attacks more likely. Some patients may consider having the operation to reduce the risk of heart attack, even if they do not have troublesome angina.
Effect on patients
This is a big operation. It is not terribly painful, but there is pain afterwards. Usually the chest, back, neck, shoulders and legs can hurt, but this is easily treated with standard painkillers.
The operation also makes patients feel tired and lacking in energy for the first few weeks.
Usually, angina disappears completely immediately after the operation and stays away for years. In many patients the risk of heart attack is also much less once they have recovered from the operation.
What happens during the operation
The operation is done under general anaesthetic. The anaesthetist puts in many tubes and drips to monitor the patient and to give medicines. The chest is cut over the breastbone. The surgeon then takes a vein (usually from the leg) or artery (usually from inside the chest) and uses it to create a bypass around the blockage in the coronary artery. More than one bypass may be done, depending on how many blockages there are. Often a heart-lung machine is used to keep the blood circulating while the heart is stopped for surgery. Sometimes it is possible to do the operation without a machine (on the beating heart). When the bypasses are done, the heart is restarted, the machine stopped and the wounds are closed.
What to expect afterwards
You stay overnight in the intensive care unit and about four to eight days recovering on the ward. Most tubes are removed in the first two days. You can have food and drink on the day after the operation, but your appetite may be poor in the first few days. You may sit in a chair on the first day, walk to the toilet on the second and walk about the ward from the third or fourth day. Once you can climb a flight of stairs, it is nearly time to go home.
Rehabilitation
You are encouraged to be active and to go for walks after leaving hospital. The general rule is that most things are allowed if you feel up to them, apart from activities which may delay the healing of the breastbone (heavy lifting or other activities which stress the upper arms are banned for three months after the operation). By six weeks, most patients feel almost normal and are active enough to appreciate that their angina is no longer there.
Rates of survival after heart bypass operations
- Aberdeen Royal Infirmary
- Royal Victoria Hospital Belfast
- Blackpool Victoria Hospital
- Bristol Royal Infirmary
- Coventry Walsgrave Hospital
- Essex Cardio -thoracic
- Glasgow Royal Infirmary
- Golden Julilee
- Hull Castle Hill Hospital
- Leicester Glenfield Hospital
- London Bart's and the London
- London Harley Street
- London Imperial College
- London The Heart Hospital
- London London Bridge Hospital
- London St Anthony's
- London St George's Hospital
- Manchester Royal Infirmary
- Middlesbrough James Cook University Hospital
- Nottingham University Hospital
- Papworth Papworth Hospital
- Sheffield Northern General Hospital
- Stoke on Trent N Staffordshire Royal Infirmary
- Wolverhampton New Cross Hospital