Bypass surgery is a type of heart surgery performed to relieve angina and reduce the risk of death from coronary artery disease. Arteries and veins from the suitable part of the patient's body are grafted to the coronary arteries to bypass atherosclerotic narrowing. The surgery is generally performed with the heart stopped, necessitating the usage of cardiopulmonary bypass; techniques are available to perform coronary artery bypass graft (CABG) on a beating heart, so-called "off-pump" surgery.

Why is Bypass Surgery required?

The artery (coronary artery) that brings blood to the heart muscles may become clogged due to plaque (a build-up of fat, cholesterol and other substances). This can slow or block the flow of blood through the heart's blood vessels, causing chest pain or a heart attack. Restoring or increasing blood flow to the heart muscle can relieve chest pain and reduce the risk of heart attack.

The major focus of the bypass surgery is to:

• Improve your quality of life and decrease angina and other symptoms of coronary artery disease (CAD)
• Resume a more active lifestyle
• Improve the pumping action of the heart if it has been damaged by a heart attack
• Lower the chances of a heart attack (in some patients, such as those with diabetes)
• Improve your chance of survival

Who needs CABG?

Coronary artery bypass graft surgery is only used to treat people who have severe CAD that could lead to a heart attack. The doctor may recommend surgery if other treatments, such as lifestyle changes or medicines fail to control the situation. He or she may also recommend surgery if the patient has severe blockages in the large coronary arteries that supply a major part of the heart muscle with blood.

What to expect before Bypass Surgery?

Various tests are done to prepare the individual for CABG. These tests include blood tests, electrocardiogram, echocardiogram, chest x-ray, and cardiac catheterization.

The doctor provides the patients with a specific set of instructions about how to prepare for surgery. There will be instructions about what to eat or drink, what medicines to take, and what activities to stop.

What to expect during surgery?

Coronary artery bypass graft surgery requires a team of experts. A cardiothoracic surgeon performs the surgery with support from an anesthesiologist, perfusionist (heart-lung machine specialist), other surgeons, and nurses.

There are several different types of bypass surgeries ranging from open heart surgery to a modern surgery in which small incisions are made to bypass the narrowed artery.

What to expect after CABG?

You will have to spend 1 or 2 days under observation in the intensive care unit (ICU) after surgery. The heart rate and blood pressure will be continuously monitored during this time. Intravenous medicines (medicines injected through a vein) are often given to regulate blood circulation and pressure. You will then be moved to less intensive care area of the hospital for 3 to 5 days before being discharged.