Coronary Artery Bypass Surgery

What To Expect

After surgery, there will be a short stay (1 to 2 days if there are no complications) in the intensive care unit (ICU). In the ICU, you will likely have:

• Continuous monitoring of your heart activity.
• A tube to temporarily help with breathing.
• A stomach tube, to remove stomach secretions until you start eating again.
• A tube (catheter) to drain the bladder and measure urine output.
• Tubes connected to veins in the arms (intravenous, or IV, lines) through which fluids, nutrition, and medicine can be given.
• An arterial line to measure blood pressure.
• Chest tubes, to drain the chest cavity of fluid and blood (which is temporary and normal) after surgery.

You will typically stay in the hospital from 3 to 8 days after open-chest bypass surgery. The amount of time you stay varies and will depend on your health before bypass surgery and whether complications develop from surgery.

After discharge, recovery at home takes 4 to 6 weeks. Exercise and driving may be resumed after about 2 to 3 weeks. People who are able to return to work can usually do so within 1 to 2 months, depending on the type of work they do.

Some people find that they experience heightened emotions (such as a greater tendency to cry or otherwise show emotion in ways that are unusual compared with before the procedure) for up to a year following surgery.

Cardiac rehabilitation

After your surgery, your doctor may suggest that you attend a cardiac rehabilitation program. In cardiac rehab, a team of health professionals provides education and support to help you recover. Recovery includes physical therapy, respiratory therapy, occupational therapy, and diet counseling.

The rehab team can help you make new, healthy habits, such as eating right and getting more exercise.

Lifestyle changes and medicines

The success of bypass surgery also depends on you. You can do things that can help you stay healthy and prevent problems. You will take medicines, and you may need to make lifestyle changes. These things help your bypass grafts last and stay open longer.

If you smoke and don't quit, you won't get the most benefit from bypass surgery. You may need to make some other big changes, like eating right, getting regular exercise, and losing weight. A cardiac rehab program can help you make these lifestyle changes.

You will likely take medicines that prevent blood clots, lower cholesterol, and manage blood pressure. Along with lifestyle changes, these medicines can help you get the most benefit from bypass surgery.

Bypass surgery is not a cure for heart disease. That's why medicine and lifestyle changes are so important. Without them, you raise your risk of getting new places in your arteries that are narrowed or blocked. If this happens, you may need another surgery.

More Information

• How will I recover from bypass surgery?
• What will my first 24 hours of recovery be like?
• What will my recovery be like after the first 24 hours?
• What can I expect when I go home after surgery?
• What happens in a cardiac rehabilitation program?
• What can I do to help my recovery from bypass surgery?
• How can I help a loved one who has had bypass surgery?

How Well It Works

Bypass surgery can:

• Relieve angina symptoms and improve quality of life. You may be able to do more of your daily activities.^{footnote 1}
• Help some people live longer. Whether it could help you live longer depends on several things. These include your overall health and which arteries need to be bypassed. For example, the surgery may raise your chances of living longer if you have diabetes and narrowing in your heart's larger arteries.^{footnote 2, footnote 3}

What To Think About

When bypass surgery is clearly needed, surgery improves symptoms and in some cases prolongs life. But in many situations, the reasons for doing bypass surgery instead of other treatments are less clear.

In each case, the cardiac surgeon or cardiologist should be able to clearly explain why bypass surgery is preferred over medicine or angioplasty. Sometimes, a second opinion can be helpful when it is not clear that surgery needs to be done.

Transmyocardial laser revascularization (TMR) is sometimes used along with bypass surgery. TMR uses a laser beam to improve blood flow to the heart and relieve angina. It is not common but may be done to reach areas of the heart where bypass grafting does not work as well. And it is not the right treatment for everyone.