(Image source: File picture of a coronary bypass surgery in 1981 by Jerry Hecht)

You have been feeling breathless and having bad chest pains. After several tests, your doctor tells you that you have blockages in several of your heart blood vessels, and that you will need coronary artery bypass surgery.

What is it?

Bypass surgery is a form of open-heart surgery that redirects blood flow around a blocked artery.

In this procedure, a cardiothoracic surgeon will take a healthy blood vessel from another part of your body (such as your leg, arm or chest), and connect it above and below the blocked area to provide a ‘detour’ for blood flow. The same is done for other blocked vessels.

The procedure is called open-heart surgery because the surgeon will make a cut in the chest to open it up. During the procedure, your heart will be stopped and you will be connected to a heart-lung machine that helps keep blood and oxygen flowing through your body.

(In some cases, the heart is left beating and special equipment is used to stabilise a certain area of the heart.)

You will be put under general anaesthesia for this surgery, which may take three to six hours.

What are the risks?

Advancements in the field have made cardiac anaesthesia and surgery very safe.

“The risk of open-heart surgery is very small, less than one per cent," says consultant cardiothoracic surgeon Tan Sri Dato’ Dr Yahya Awang, one of the pioneers who set up the National Heart Institute in 1992.

Nevertheless, there are still some risks to the procedure, and your surgeon or anaesthetist should clearly explain these risks to you. These may include bleeding, infection and an irregular heartbeat.

There may also be a serious risk of heart attack or stroke. All of these risks depend on your health, such as whether you have other medical conditions like diabetes or kidney disease.

If you are worried, ask your surgeon about your risks.

Recovering from a bypass

After the surgery, you may need to spend one or two days in the intensive care unit (ICU). Overall, you’ll spend about a week in the hospital before the medical team discharges you.

You may need cardiac rehabilitation while in the hospital, where you’ll be taught exercises and heart-healthy lifestyle changes.

Recovery can be slow, so take it easy. Initially, you’ll probably find it difficult to do daily tasks or walk short distances.

Look out for the following signs and call your doctor if you experience them:

Fever
Rapid heart rate
New or worsened pain around your chest wound
Area around your chest wound getting red; bleeding or other discharge from the wound

After six weeks, you should be able to resume activities like working, driving and having sex. You should be fully recovered by 12 weeks.

Staying healthy after a bypass

Bypass surgery doesn’t cure heart disease. Your symptoms of breathlessness and chest pains will go away, but other arteries or the grafted vessel may become blocked again. If that happens, you may need another bypass or angioplasty again.

In the long run, the only way to prevent further blockages or even a heart attack is to follow your doctor’s advice on lowering your risk. Take your medications as prescribed and follow all the necessary steps to lower your blood pressure and cholesterol, and control your diabetes.

Other changes that will reduce your risk are:

Stopping smoking
Eating a healthy diet
Maintaining a healthy weight
Exercising regularly
Managing stress

Listen to the podcast ‘Coronary Artery Bypass Graft’:

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